极低出生体重儿颅内出血诱因及诊治

THE CAUSE, DIAGNOSIS AND TREATMENT OF INTRACRANIAL HEMORRHAGE IN VERY LOW BIRTH WEIGHT INFANT

为探讨极低出生体重儿颅内出血诱因、影像学诊断、预防、预后，我们总结了我院近二年间极低出生体重儿颅内出血情况。发现窒息、小胎龄、前五胎盘、胎盘早剥等产科并发症是颅内出血重要诱因，鲁米那预防性治疗早期应用才有效。颅内出血中以脑室内出血最多，Ⅲ°～Ⅳ°脑室内出血、脑实质出血、脑室周围出血预后差。新生儿期定期Ｂ超检查可及时发现脑积水、脑室周围白质软化，一岁左右复查时宜选用磁共振，以提高脑室周围白质软化诊断率。

To detect the cause, image diagnosis, prophylaxis and prognosis of intracra- nial hemorrhage in very low birth weight infant. Methods: All of very low birth weight in- fant with intracranial hemorrhage treated in our hospital last two year's had been summer- ized. Results: Obstetrical complications Such as asphyxia、smaller gestational age、 plcaenta prerial. abruptio placenta were important causes of intracranial hemorrhage, the earlier it was prophylactic treated with hpenobarbital, the more effective it was. Intraventricular hem- orrhage was the most common intracranial hemorrhage, and it had poor outcome that hemor- rhage occured in Ⅲ-Ⅳ ventricular, cerebral matter and peri-ventricular. Conclusion: Hydro- cephalus and periventricular leukomalacia may be earlierly find by ultrasonic exmination at interfals in newborn, but MRI is applicable for one year's infant to improve the positive rate of periventricular lenkomalacia.