STUDY OF NEONATAL INTRACRANIAL HAEMORRHAGE AND HYPOXIC ISCHEMIC ENCEPHALOPATHY

A series of 100 cases of newborn babies of Apgar scores ≤7 or gestationage ≤32 weeks were studied by head ultrasonography (US) and CT scans. Forty-twopoint four percent of the cerebral lesions observed was subependymal-intraventricularhaemorrhage (SEH-IVH), 24.1% of which was in preterm infants and 18. 3% infull-terms, 7. 6% had subdural haemorrhage (SDH), 6. 3% had intraparenchymalhaemorrhage (IPH), 2.5% had subarachnoid haemorrhage (SAH) and 1.9% hadintracerebellar haemorrhage (ICEH). Sixteen point five percent were diagnosed ashypoxic-ischemic encephalopathy (HIE). The diagnostic accuracy of cerebralultrasonography was 82.8% by comparing with necropsy findings in 14 infants. Agreementbetween US and CT scan was 63.3%. The study shows that it was not easy to distinguishHIE from intracranial haemorrhage (ICH) clinically, the US and CT scans may be neces-sary. We revealed that the clinical severity of HIE did not follow the degree of CTchanges, and US was more sensitive in SEH-IVH, however, SDH was more sensitive inCT scans. Neurodevelopmental follow-ups were performed at 1.5-24 months (mean 7.5months) in 76 survival infants. Twenty-three of these infants (30. 3%) hadventriculomegaly. The mental and psychomotor performances on the Bayley scales were ab-normal in 33.3% (12/36) infants. Eight infants were noted to have major handicapsincluding impaired vision, diplegia, epilepsy or/and severe developmental delay.     

新生儿颅内出血和缺氧缺血脑损伤的早期诊断和随访研究

采用头颅超声对100例出生时有窒息的新生儿或胎龄≤32周早产儿进行了检查.并配合CT及脑病理解剖进行了对照研究。其中空管膜下—脑室内出血(SEH—IVH)发病率最高为42.4％。其次为缺氧缺血性脑病(HIE)占16.5％。尸解证实超声诊断的正确率为82.8％。超声与CT诊断的符合率为63.3％。成活婴儿在出院后进行了定期的体格和智力发育的随访。     

围产期窒息婴儿的头颅CT检查

目前,围产期婴儿窒息对新生儿发病率和死亡率仍占有很大比重,仍然是新生儿死亡和以后神经系统发育障碍的主要原因。但颅脑影象诊断过去一直是一个未能很好涉足的领域,在新生儿存活期间很难进行颅内病变的诊断。近十年来,CT和B超的相继问世较好地解决了这个问题。本文仅就CT诊断作一综述。一概况 CT用于新生儿颅内出血的诊断是从1976年开始的,通过大量研究及尸解证实,认为脑CT对于新生儿颅内出血的诊断尤其有价值,可确诊颅内出血的部位和程     

多胺与早期生长发育

多胺是在生物体内广泛存在的一类多价正离子性脂肪族胺,包括精眯、精胺、腐胺和尸胺。近年来的研究发现体内多胺的变化反映了细胞动力学方面的改变,反映了细胞和组织生长发育的情况。通过检测孕妇血、尿、羊水及胎儿或新生儿血和/或尿中多胺,可评估胎儿或新生儿个体或各系统脏器早期生长发育的情况。     

谈谈小儿的紧张性行为问题及其他

儿科临床医师终日与病儿接触,着眼于疾病的症状鉴别与诊断治疗,往往会发现一些不易用一般病理生理来解释的现象,也会观察到一些病儿的性格病态。医病也要医人,儿童心理的研究以及对健康和品德的影响也应当是儿科医师的工作范围。老教授的经验之谈提醒各级儿科医师应当全面分析病情,也应分析环境的影响,指导家长共同养好育好下一代,这也是当代世界上儿科医学的一个重点发展方向。     

远红外开放式保暖床的临床使用

本文观察25例临床使用远红外开放式保暖床,其中有早产儿、硬肿症、低温等病婴,难产及平产的新生婴儿,低温者复温时间为2～7小时直肠温度升高1.1～10.5℃,放床时间最长者为6(1/2)天,且于床上进行气管插管、应用人工呼吸器等,便于观察、抢救且能自动控制皮肤温度。本文对所有刚出生婴儿分平产组与难产组放置保暖床结扎脐带或复苏,与未放床的平产组、难产组各自对照,比较出生后30分钟时体温下降的情况及体温恢复到正常所需的时间,结果放床组比未放床组体温下降少,而且恢复到正常体温所需时间较快。     

必需脂肪酸与婴儿营养

自从1929年Burr等在动物实验中观察到喂养无脂肪的食物对大鼠的生长产生不利的影响后,必需脂肪酸(简称EFA)在营养上的重要性日益受到重视。随着全静脉营养(TPN)在儿科临床的应用,已观察到一些长期接受无脂肪静脉营养的小儿出现了一系列症状,而在补充EFA后可使症状迅速改善。EFA是一组天然产生的,链长18、20或22个碳原子,有2～6个双键以顺式构型排列的多不饱和脂肪酸(PUFA),为人体和高等动     

CRANIAL CT SCANNING IN PERINATAL ASPHYXIA AND HIGH-RISK NEONATES

We employed cranial CT scan to detect intracranial changes in perinatal asphyxia (27 cases) and some high-risk neonates(7 cases) at an average of 3.6 days after birth. There was a 91% positive CT findings. Two main categories of CT abnormalities were found: intracranial hemorrhage 26 and hypoxic/ischemic brain damage 5. 4 different types of intracranial hemorrhage were seen: (1) intraventricular hemorrhage (IVH) 4; (2) subdural hemorrhage (SDH) 19; (3) intracerebral hemorrhage (ICH) 1 and (4) subarachnoid hemorrhage 2. The high morbidity of SDH in our study was ascribed to trauma sustained during prolonged labor. All the 4 cases with IVH were infants less than 32 weeks of gestational age, suggesting the existence of subependymal germinal matrices in these infants. The one with ICH developed porencephaly later. Intracranial hemorrhage resolved within 2-3 weeks. 10 of the 34 neonates died. Autopsy was performed on 7 and pathologic findings were in accordance with CT findings.     

8例慢性缺氧小样儿血清红细胞生成素水平的观察

红细胞生成素(Erythropoietin,EPO)是一种糖蛋白激素,专门参与调节红细胞的生成。当人体血氧浓度发生变化时,组织和细胞的供氧受到影响,血EPO的浓度也发生相应的改变,结果刺激或减少红细胞生成的数量,以维持组织和细胞的正常生理功能。小样儿的发生与胎儿在宫内的缺氧有密切     

低出生体重儿糖耐量的初步研究

本文报道28例低出生体重儿39次葡萄糖负荷试验的初步研究结果,发现临床情况良好者耐糖佳(尿糖阳性率为41%);而临床情况差者耐糖不良(尿糖阳性率为65%),特别在负荷试验90分钟及180分钟时两者血糖值有显著差异。通过负荷试验最高血糖值与尿糖阳性率之间关系的分析,以100毫克/分升作为高血糖界限,临床情况良好者即使有高血糖出现,但不一定出现尿糖;反之,临床情况差者,血糖值在100毫克/分升以下,亦可出现尿糖。本文同时发现耐糖与胎龄也有关系,眙龄越小或出生体重越低,则尿糖阳性率越高,可能与宫内因素有关。而出生后日龄超过6天时,则耐糖能力可明显提高。