110例早产儿头颅B超检查结果分析

Analysis on the results of cerebral B-ultrasound inspection in 110 preterm infants

目的:探讨NICU早产儿颅内出血的影响因素及早期临床表现特征,以便及时诊断、指导治疗和判断预后。方法:2007年9月～2009年1月NICU住院的110例早产儿(胎龄<37周)于生后7天内行头颅B超检查,同时记录其临床表现,并分为颅内出血组和对照组,采用SPSS11.5软件包对结果进行统计分析。结果:共63例早产儿确诊为颅内出血,发生率为57.27%;胎龄<34周早产儿,极低出生体重儿及低出生体重儿颅内出血的发生率与胎龄>34周早产儿、正常出生体重儿之间比较差异均有统计学意义(χ2=7.133,P<0.05;χ2=11.181,P<0.05);存在围产期高危因素的早产儿颅内出血发生率明显增加(χ2=6.277,P<0.05),但Apgar评分不同,早产儿颅内出血发生率差异无统计学意义(χ2=3.211,P>0.05);早产儿颅内出血早期常无症状或者症状不典型,与对照组相比差异无统计学意义(χ2=4.073,P>0.05)。结论:胎龄小、体重低以及存在围产期高危因素的早产儿颅内出血的发生率明显增高,但其临床表现无特异性,Apgar评分异常与颅内出血的发生无显著相关,对所有早产儿常规行头颅B超检查,做到早期诊断,对指导治疗和预后均具有非常重要的意义。

Objective：To explore the effect factors and characteristics of early clinical manifestations of intracranial hemorrhage of preterm infants in NICU,in order to diagnose timely,direct treatment and predict prognosis. Methods：110 preterm infants（gestational weeks37 weeks） who hospitalized in the hospital from September 2007 to January 2009 received cerebral B-ultrasound inspection within 7 days after birth,at the same time,the clinical manifestations were recorded,then the preterm infants were divided into intracranial hemorrhage group and control group,SPSS11.5 software was used for statistical analysis. Results：Totally,63 preterm infants were diagnosed with intracranial hemorrhage and the incidence was 57.27%.There was significant difference in the incidence of intracranial hemorrhage between the preterm infants with gestational weeks34 weeks,very low birth weight infants,low birth weight infants and the preterm infants with gestational weeks34 weeks,normal birth weight infants（χ2=7.133,P0.01;χ2=11.181,P0.01）.The incidence of intracranial hemorrhage in preterm infants with high risk factors during perinatal period increased significantly（χ2=6.277,P0.05）,but there was no significant difference in the incidence of intracranial hemorrhage among the preterm infants with different Apgar scores（χ2=3.211,P0.05）;the symptoms of intracranial hemorrhage in preterm infants were absent or atypical,compared with control group,there was no significant difference（χ2=4.073,P0.05）. Conclusion：The incidences of intracranial hemorrhage in preterm infants with small gestational weeks,low birth weight and related high risk factors during perinatal period increase obviously,but the clinical manifestations have no specificity,there is no significant correlation between abnormal Apgar score and the occurrence of intracranial hemorrhage;carrying out regular cerebral B-ultrasound inspection among the preterm infants and early diagnosis have very important significances for direction of treatment and prognosis.