早产儿脑室周围-脑室内出血临床观察

目的:探讨早产儿脑室周围-脑室内出血(periventricular-intraventricu lar hemorrhage,PV-IVH)特点及影响因素,寻求降低早产儿PV-IVH发生率及严重度的有效方法。方法:72例胎龄28~35周早产儿于生后24 h内、满1、2、3、5、7 d,分别行颅脑超声检查。结果:①早产儿PV-IVH发生率为69.4%,重度PV-IVH发生率为31.9%;92%PV-IVH在宫内、产时或生后24 h之内发生;30%进一步发展;发生与否及严重程度除表现为神经系统症状外无其他特异性临床表现。②机械通气、胎龄和地塞米松是与早产儿PV-IVH有关的独立因素。结论:①早产儿PV-IVH发生率高,发生时间早,会进一步发展,常无典型症状及体征,应早期、续贯监测。②防治措施为积极预防早产;产前积极使用地塞米松;减少机械通气等。

The clinical study of periventricular-intraventricular hemorrhage in preterm infants

Objective:To study the characteristics and influence factors of periventricular-intraventricular haemorrhage(PV-IVH) and to find out some methods to reduce the morbidity or severity of PV-IVH.Methods:Method:Serial cerebral ultrasound scans were performed in the preterm infants born from 28 to 35 weeks' gestational age in the 0,1st,2nd,3rd,5th,7th day of life.Results:①The morbidity of PV-IVH in preterm infants was 69.4%.Severe intracranial haemorrhage was 31.9%.92% preterm infants had already been suffered from PV-IVH in uterus,during the labor or within the first 24 hours of life and 30% PV-IVH would develop.There were not special clinical features except neural abnormities.②Mechanical ventilation,gestational age and prenatal steroids treatment were the independency influence factors of PV-IVH.Conclusion:①The morbidity of PV-IVH is quite high in preterm infants.It happens very early and could develop after birth without obvious clinical appearance.The screening should be performed early and continually.②Prolonging the gestational age of prematurity,antenatal exposure to steroids to prevent the use of ventilation could be the ways to prevent the happening or developing of PV-IVH.