感染与早产儿脑损伤临床关系探讨

Discussion on the Relationship Between the Infection and the Brain injury of Premature Infant

目的:探讨感染与早产儿脑损伤(HIE,ICH,CWMD)的临床表现,治疗,预后和预防的关系。方法:对2000年1月-2006年10月214例早产儿进行临床分析。结果:胎膜早破32例,母亲妊高症23例,胎儿宫内窘迫33例,脐带扭转打结7人,母亲妊娠糖尿病4人,胎儿畸形4人;早产儿肺炎101人,早产儿寒冷损伤综合征7人,早产儿急性坏死性小肠结肠炎5人,低血糖症27人,低血钙症13人,早产儿缺氧缺血性脑病(HIE)76人,早产儿颅内出血(ICH)21人,早产儿脑白质损伤(CWMD)3人。早期诊断、合理抗感染治疗可减少早产儿HIE及ICH以及CWMD患儿的神经系统后遗症。结论:早产儿感染与HIE及ICH以及CWMD的关系密切,预防产前、产时、产后感染对减少或减轻早产儿脑损伤至关重要。

Objective：To approach the relations between the infection and clinical situation, therapy, prognosis, and prevention of the premature infant＇s brain injury （ HIE, ICH, CWMD ）. Methods：The clinical analysis was done on 214 cases of premature infants born during from Jan., 2000 year to Oct., 2006. Results：32 cases for premature rupture of membrane, 23 cases for gestational hypertension disease of mother, 33 cases for fetal distress in uterus, 7 cases for torsion and ligature of umbilical cord, 4 cases for gestafional diabetes of mother, 4 cases for fetal anomaly, 101 cases for pneumonia of premature infant, 7 cases for cold injury syndrome of premature infant, 5 cases for acute necrotizing enterocolitis （NEC） of premature infant, 27 cases for hypoglycemia, 13 cases for hypocalcemia, 76 cases for hypoxic-ischemic encephalopathy （HIE）, 21 cases for ICH, 3 case for CWMD. For the premature infants of HIE, ICH, or CWMD, the early diagnosing and reasonable anti-infection therapy could decrease the odds of sequela of the nervous system caused by the infection. Conclusion：For premature infants, the infection has a close relationship with HIE, ICH （ intracranial haemorrhage ）, or CWMD. It is of the utmost importance for decreasing or easing brain injury（BI） to prevent the antepartum infection, intrapartum infection and postnatal infection （PND.