新生儿颅内出血的CT特征及临床分析

目的为探讨各种类型新生儿颅内出血早期诊断方法,明确其临床特点与CT的关系。方法对本院近6年来CT证实有颅内出血的住院新生儿的临床资料进行回顾性分析。结果176例患儿中缺氧所致123例(72.6%),产伤21例(11.9%),新生儿出血症22例(12.5%),早产儿10例。患儿有意识障碍者156例(88.6%),惊厥98例(55.68%),肌张力改变113例(64.2%),原始反射减弱或消失104例(59%),贫血16例。CT示出SAH 121例占68.75%,为NICH最常见类型,SDH 17例占9.66%,IPH 13例,IVH5例,混合性出血20例。结论凡有窒息史、异常分娩史,系产伤、早产儿、低出生体重儿、出生后未注射过VitK1的小儿,应严密监测神志改变、前囟、瞳孔、呼吸节律、惊厥、肌张力及原始反射及有无贫血,一旦有上述病史体征,应想到NICH可能,有条件者常规头颅CT或头颅B超检查。CT是确诊的最佳手段,能正确显示出血部位、范围、程度及区分各种类型,头颅B超对早产儿、低出生体重儿的IVHI、PH检出率高。

Cranial CT feature and clinical analysis of neonatel intracranial hemorrhage: clionicalanalysis of 50 cases

Objective To discuss the early diagnosis methods of varies of neonatal intracranial hemorrhage(ICH),to investigate the relation between cranial CT and clinical cases.Methods To analyse 176 cases of ICH that were examined by cranial CT last six years in our hospital.Results Hypoxia was 123cases(72.6%),birth trauma was 21 cases(11.9%),neonatal hemorrhage was 22 cases(12.5%),premature was 10 cases(5.68%),altered states of consciousness was 156 cases(88.6%),convulsion was 98 cases(55.68%),altered states of muscule tone was 113 cases(64.2%),primary reflex faintly or disappear was 104 cases(59%),anemia was 16 cases.Cranial CT shows that SAH 121 cases(68.75%) was very common type;SDH was 17 cases,IPH was 13cases,mixed hemorrhage was 20 cases.Conclusion The neonates with hypoxia,abnormal laber,birth trauma and premature,especially <32weeks low birth weight,uninjected VitK1 ought to be monitored state of consciouness, tone of fontanel,size of pupil,rhythm of breath,convulsion,altered state of muscle tone and primary reflex,anemia,and be examined with ultrasound or cranial CT.The best method is cranial CT scan,can accuratyely show location,arrange,degree of hemorrhage,and distinguish type of hemorrhage.Cranial ultrasound is high diagnosis rate for IVH,IPH of premature and low birth weight.