新生儿颅内出血的CT诊断价值研究

目的 研究新生儿颅内出血的原因及CT的诊断价值与临床意义,提高临床诊断与CT诊断的符合率.方法 回顾性分析新生儿颅内出血660例的临床资料及CT资料.结果 缺氧缺血性脑病合并颅内出血590例,占89.4%,维生素K缺乏合并颅内出血66例,占10.0%;产钳伤致颅内出血4例,占0.6%.脑内血肿32例,占4.8%;脑室出血18例,占2.7%;硬膜外血肿2例,占0.4%.结论 缺氧缺血性脑病合并颅内出血最多见,维生素K缺乏合并颅内出血次之.CT能明确诊断绝大多数新生儿的颅内出血,故临床疑有新生儿颅内出血者（特别是缺氧缺血性脑病和维生素K缺乏的新生儿）应尽早行CT检查.但部分CT征象不典型的新生儿颅内出血需结合临床其他资料诊断.CT对指导临床出血分型、早期治疗、随访观察、预后估计及预防并发症等均有重要的价值.

Analysis and research of CT diagnosis value and image tracking of newborn baby with intracranial hemorrhage

Objective To research the reasons for intracranial hemorrhage of newborn babies and diagnosis value of CT and its clinical significance, and to raise the coincidence of clinical diagnosis and CT diagnosis. Methods The clinical and CT material of six hundred and sixty cases diagnosed as intracranial hemorrhage of newborn babies were retro- spectively analyzed. Results Among them, 590 cases with hypoxic ischemic encephalopathy （HIE） and intracranial hemorrhage, accounted for 89.4%; 66 cases with vitamin-K deficiency and intracranial hemorrhage, accounted for 10.0%; 4 cases of intracranial hemorrhage because of forceps injury, accounted for 0.6%; 32 cases of intracerebral hematoma, accounted for 4.8%; 18 cases of ventricular hemorrhage, accounted for 2.7%; 2 cases of epidural hematoma, accounted for 0.4%. Conclusion HIE accompanied with intracranial hemorrhage is the most common one, followed by vitamin-K deficiency and intracranial hemorrhage. We can diagnose clearly most intracranial hemorrhage of newborn babies by CT, therefore, the clinical suspicious newborn babies with intracranial hemorrhage （especially the newborn babies with HIE and vitamin-K deficiency） should take CT examination as early as possible. While for some intraeranial hemorrhage of newborn babies without typical CT signs, they should be diagnosed connecting with other clinical materials. There is great value of CT for guiding the clinical blood typing, early treatment, follow-up observation, esti- mation of prognosis, prevention of complications, etc.