摘要
目的 探讨高危新生儿室管膜下出血（SHE）／脑室内出血（IVH）发生率与程度及与其相关的产科危险因素的关系。方法 从2001年1月～2006年10月我们对本院收治及留观的4026例高危新生儿，于生后3天均进行前瞻性颅内超声检查，将产科资料完整的3626例高危新生儿作为研究对象，用列联表分析SHE／IVH（SIVH）发生率与产科危险因素的关系。结果 最常见的脑异常是室管膜下囊肿（SEC）9．5％，其次是SIVH5．2％，罕见的有脉胳膜丛囊肿（CPC），脑积水，小脑延髓池增大（ECC），脑室周围白质软化（PVL），脑穿通畸形。胎儿宫内发育迟缓，胎儿宫内窘迫，胎膜早破，孕高征，产程延长时SIVH的发生率增高。SIVH的发生率随着胎龄的减少而逐渐增加，其发生率分别是：38～43周为2．4％，34～36周为6．6％，31～33周为19．5％，27～30周为56．6％。早产儿sIVH的发生率与阿氏评分呈负相关，足月儿阿氏评分0～3分时，SIVH发生率才升高。结论 本研究结果提示SIVH的发生率与胎龄及低阿氏评分密切相关；且受产前产时各种危险因素影响，为了减少高危新生儿SIVH的发生率，应加强围产期保健，预防早产，减少窒息的发生。
Objective To investigate the incidence and severity of brain damage in high risk neonates and relate them to various obstetrical risk factors. Methods All high risk neonates born between 2001 and 2006 were included in the study （n=4026） and were screened by prospective ultrasound for cerebral abnormalities on 1-3days post-partum, the relation between the incidence subendymal/intraventricular hemorrhage（SIVH）and obstrical risk factors were analyzed by contingency tables .Results The most frequent abnormality was subendymal cyst （9.5%）.SIVH was second （5.2%）o choroid plexus cyst ,hydrocephalus, Enlarged cerebellumedullary cistern, Periventricular leucomalacia, porencephalia were rare （〈0.5%）.The incidence of SIVH was increased in growth retarded fetuses, fetal distress interuterus, premature rupture of membrace and gestosis. In preterms at 34-36 weeks with prolonged labour, the incidence of SIVH was very high（11.1%）The incidence of SIVH increased progressively with decreasing gestational, e.g. from 2.4% at 37-43 weeks up to 56.6%at 27- 30 weeks of gestationg, in immature neonates there was a close inverse relationship between Apgar score at 1 min and both incidence and severity of SIVH. This was in contrast to findings in mature neonates where a marked increase in the incidence of SIVH was found only with Apgar scores as low as 0-3 points. Conclusion From the present study we conclude that the incidence of SIVH especially in immature neonates is highly associated with low Apgar scores at birth, and is influenced by various ante-and intranatal risk factors. Avoiding premature, decredsing asphyxia and protective obstetrical management is necessary to reduce the incidence of SIVH in high risk neonates.
出处
《国际医药卫生导报》
2007年第5期13-18,共6页
International Medicine and Health Guidance News
关键词
颅内超声
室管镜下/脑室内出血
高危新生儿
产科危险因素
Cranial ultrasound Sub/intraventricular haemorrhage high risk neonates, Obstetrical risk factors
