早产儿脑室内出血的超声诊断

目的探讨早产儿脑室内出血（IVH）发生的影响因素，以及床旁颅脑超声检查对IVH的诊断价值。方法对171例早产儿进行床旁头颅超声检查，IVH的轻重程度按照Papile分级法分级，将胎龄、出生体重、Apgar评分等因素与总IVH发生率以及出血程度进行相关对比研究。结果早产儿IVH的发生率为61．4％，胎龄≤32周的总IVH发病率以及重度IVH发生率明显高于胎龄〉32周的患儿（P〈0．05）。出生体重≤1500g的患儿重度IVH发生率明显增高（P〈0．05）。Apgar评分与总IVH发生率以及出血程度组间比较无明显差异，但总IVH及重度IVH发生率随评分增高有递减趋势。结论早产儿IVH发生率较高，胎龄越小，出生体重越轻，IVH发生率越高，出血程度越重。早产儿在出生3d内常规进行床旁颅脑超声检查十分必要，利于早期诊断和及时治疗。

Diagnosis of intra-ventricular hemorrhage in premature neonates with trans-cranial ultrasound

Objective To discuss the mechanism and influencing factors of intra-ventricular hemorrhage （IVH） in premature neonates and to identify the diagnostic value of bedside trans-cranial ultrasound. Methods A total of 171 premature neonates were examined with bedside trans-eranial ultrasound and were classified as IVH by Papile grading method. The gestation age, birth weight and Apgar score were correlated with the incidence rate and the severity of IVH. Results The incidence of IVH in premature neonates was 61.4%. The total incidence rate of IVH （75%）and severe IVH（52.78% ）with gestation age ≤32 weeks were significantly higher than that with gestation age 〉 32 weeks （ P 〈 0.05 ）. The incidence of severe IVH was obviously high with birth weight ≤ 1500 g（ P 〈 0.05 ）. There was no significant difference between Apgar score and incidence of IVH. No significant difference between Apgar score and the severity of IVH was ob- served. But the incidence of IVH and severe IVH decreased along with an increase of Apgar score. The incidence of severe IVH was high with birth weight ≤1500 g and gestation age ≤32 weeks. Conelusion The incidence of IVH is higher in groups of subjects in premature neonates. The smaller gestation age and lower birth weight indicate the higher incidence rate of IVH . The bedside trans-cranial ultrasonic examinations in those premature neonates who are within 3 days after birth is necessary for early diagnosis and treatment.