小于胎龄儿神经及智能发育的远期预后

Long Term Follow-up of Neurological and Mental Development in SGA Infants

71例小于胎龄儿,其中52例新生儿期曾作头颅CT扫描,阴性10例,阳性42例,包括各型颅内出血及脑水肿。出院后10～42月作神经智能发育测定:38例(53.5％)正常,13例(18.3％)可疑,异常20例(28.2％)。神经系统异常者14例,包括脑瘫及癫痫,其中8 例CT扫描复查除2例正常外,其他有脑室、沟扩大5例,脑软化灶1例。围产因素中窒息、颅内出血、低血糖以及宫内感染与预后有密切关系。

Presented in this paper is a report of 71 SGA infants, of whom 52 had CT scan during neonatal period. Among these 52 infants 10 were found to have normal CT findings, and the remaining 42 abnormal CT findings, including various types of intracranial hemorrhage and brain edema. 10-42 months after discharge from hospital, a neurodevelopmental assessment (Gesell) was performed in all infants. It was found that 38(53.5%)had normal developmental quotient(DQ), 13(18.3%) suspected findings, and 20 (28.2%) abnormal DQ. Besides, 14 infants had neurological handicaps, including cerebral palsy and epilepsy, and 8 of them had CT scan follow-up, of whom 2 were found normal while 6 had ventricular, sulcus dilation and leukomalacia. From the foregoing it may be suggested that prognosis is closely related to the perinatal asphyxia, hypoxic-ischemic encephalopathy, hypoglycemia and intrauterinc inf ection.