出生3天内新生儿惊厥65例分析

Convulsions in neonate within 3 days

目的探讨出生３天内新生儿惊厥的临床特征及其脑损伤防治途径。方法对出生３天内新生儿惊厥６５例进行临床分析，研究其惊厥发作特点、病因、疗效及预后。结果出生３天内新生儿惊厥主要表现为轻微型、局灶型。病因：缺血缺氧性脑病４１例（６３．１％），频内出血１０例（１５．３８％），低血钙７例（１０．９％），低血糖４例（６．１５％）。６５例中７８．４６％有母异常妊娠分娩史。３７例头颅ＣＴ扫描均有脑损伤，其结果与病情严重程度密切相关。３天内惊厥控制者预后良好。结论出生３天内新生儿惊厥主要表现为皮层下发作，其发生与国产期情况密切相关。病因以缺血缺氧性脑病占首位。ＣＴ扫描对诊断脑损伤部位、范围、程度和性质有重要意义。注意围产期保健，及时诊断和处理，可减少脑损伤和后遗症。

Objective To research the clinical features of convulsions in neonate within 3 days and the way of the prevention them from brain injury.Methods The clinical analysis on 65 cases of covulsions in neonate within 3 days performed,and the attack characteristies of convulsions,pathogeny, treatment effect and prognosis were researched.Results Convulsions in neonate within 3 days mainly appears to be: the light or topical pattern.Causes of the disease were: anoxic-ischemic encephalopathy (HIE, 41 cases, 63. 1% ) the first, intracranial hemorrhage (10 cases,15. 38% ) the second, hypocalcemia (7 cases,10. 9% ) the third, hypoglycaemia (4 cases,6. 15%) the fourth. 51 of 65 cases (78.46%) had the abnormal gestation and delivery history of mother, and 37 cases shawed the brain injury of varying degrees, and the results were closely related with patients'conditions. The patients' convulsions were controlled in 3 days had a good prognosis.Conclusions Subcortical attack is the main form of manifestation. convulsions of neonate within 3 days was closely relation to the conditions of around delivery. HIE is the first essential pathogeny. The CT examining of brain is a significant way in determining the position, range, degree and nature of brain injury. Take good care in the period of around delivery, and make timely diagnosis and give prompt treatment may reduce the brain injury and sequelae.