小于胎龄儿脑发育的随访观察

目的　探讨小于胎龄儿 (SGA)出生时脑发育受影响的程度和出生后脑发育的情况 ,为有脑发育异常的 SGA进行早期干预提供依据。　方法　运用颅脑超声对 SGA的小脑进行冠状位和矢状位小脑面积、周长、纵横径及大脑半球宽度的测量 ,并与适于胎龄儿 (AGA)进行比较分析。　结果　婴儿出生时小脑面积、周长、横径及纵径与其胎龄和出生体重存在较好的相关关系 ,尤以小脑面积和周长与其胎龄和出生体重相关较好 ;大脑半球宽度也与婴儿出生体重存在较好的相关关系。出生时 SGA的脑发育落后于 AGA,出生后 SGA的脑生长速度与 AGA相似 ,但随访至 12个月时 SGA脑发育仍落后于 AGA ,SGA其他脑的异常发生率也较 AGA高。　结论　 SGA不仅在宫内脑的发育受到影响 ,而且可影响到生后脑和神经系统发育 ,故应加强围产期保健 ,制订早期干预计划 ,做好优生工作。

Follow-up on the Development of the Brain in Small for Gestational Age Infants

Objective To explore the influence factors both at birth and after birth to the brain development of small for gestational age(SGA) infants. Methods The cerebellar area, cerebellar circumference, vertical lengths of the vermis and maximum transverse width of the cerebellar body both in midline sagital view and coronal view as well as the width of cerebral hemisphere in coronal view were measured in SGA infants through anterior fontanels by inter cranial ultrasound, and the parameters were compared with that in AGA infants. Results The cerebellar area, cerebellar circumference, vertical length of the vermis and maximum transverse width of the cerebellar body both in midline sagittal view and coronal view correlated significantly with the gestational age and birth weight and the cerebellar area and circumference correlated best with the gestational age and birth weight of infants. The width of cerebral hemisphere were also correlated significantly with birth weight. The brain growth of SGA infant was retarded at birth. The rate of the brain growth and development of SGA was accelerated after birth. It was smilar to that of AGA group, but at the age of 12 months the brain development in SGA infants was still retarded. Conclusion The growth of brain both before and after birth were retarded. Better perinatal health care and early intervention after birth should be developed.