不典型新生儿颅内出血的临床特征

目的探讨不典型新生儿颅内出血的临床特征,提高早期诊断的准确率.方法2000～2005年间,我科共有152例新生儿颅内出血病例住院治疗,其中不典型颅内出血65例.对所有的病例资料作回顾性分析,对比典型与不典型新生儿颅内出血的临床表现和预后情况.结果65例不典型病例多表现为意识、肌张力、原始反射等方面轻度异常,伴蛛网膜下腔出血者最多（46例）.其分娩方式和产伤人数与典型病例组无显著性差异（P＞0.05）;早产儿比例显著较高（P＜0.05）;窒息程度较轻（P＜0.05）;治愈52例,预后较好（P＜0.05）.结论不典型新生儿颅内出血多见于早产儿,早期病情相对较轻,临床表现不明显,易导致误诊漏诊,临床医师应给予足够重视.

Clinical features of atypical intracranial hemorrhage in 65 cases of newborns

Objective To determine the clinical features of atypical intracranial hemorrhage in newborns and improve the accuracy of diagnosis in early stage.Methods During 2000 to 2005, there were 152 newborns with intracranial hemorrhage treated in our department, including 65 atypical cases. All the medical records were analyzed retrospectively, and the indications and prognosis were compared between atypical or typical cases.Results Most of the 65 atypical cases showed mild abnormality in consciousness, muscular tension, and primitive reflex. Subarachnoid hemorrhage occurred in 46 cases . The delivery pattern and birth trauma in atypical cases had no differences to those in typical ones( P >0.05).But the ratio of preterm infants in atypical cases was significantly higher ( P <0.05);the level of asphyxia was lower( P <0.05); and their prognosis was better with 52 cases of healing ( P <0.05).Conclusion Atypical intracranial hemorrhage occurs more frequently in preterm infants with milder indications. It tends to cause misdiagnosis or missed diagnosis in early stage, which should be paid sufficient attention to.