床旁颅脑超声在早产儿颅内出血诊断中的应用

Application of bedside ultrasound in diagnosis of intracranial hemorrhage in premature infants

目的探讨床旁超声在早产儿颅内出血诊断中的应用价值。方法选取我院新生儿科收治的1700例早产儿行颅脑超声检查,分析早产儿不同程度颅内出血的超声表现,以及不同胎龄、出生体质量早产儿颅内出血的发生情况。结果1)早产儿颅内出血患病率:1700例早产儿颅内出血277例,发病率16.29%,其中912例男早产儿中出血患儿146例(16.0%),788例女早产儿中出血患儿131例(16.6%),性别比较差异无统计学意义;2)胎龄<32周(833例)和≥32周(867例)的早产儿颅内出血者分别为171例(20.5%)和106例(12.2%)。与胎龄<32周早产儿比较,胎龄≥32的早产儿颅内出血发生率显著降低(P<0.05);3)出生体质量<1500 g(639例)和≥1500 g(1061例)早产儿颅内出血分别为136例(21.2%)和141例(13.2%);与出生体质量<1500 g早产儿比较,出生体质量≥1500 g早产儿颅内出血发生率显著降低(P<0.05)。结论低胎龄早产儿和低体质量早产儿颅内出血患病率较高,床旁颅脑超声为早期诊断早产儿颅内出血提供了重要依据,是筛查及监测早产儿颅内出血的首选方法。

Objective To evaluate the diagnostic value of bedside ultrasound in diagnosis of intracranial hemorrhage(ICH)in premature infants.Methods One thousand and seven hundred premature infants were examined by bedside ultrasonography,and the ultrasonic manifestations of different degrees of ICH in premature infants with different gestational age and birth weight were analyzed.Results 1)Incidence of ICH 277(16.29%)cases presented with ICH in 1700 premature infants.There were 146 cases(16.0%)of the 912 male premature infants with ICH,and 131 cases(16.6%)of the 788 female premature infants with ICH.There was no significant difference between the male and female;2)The number of ICH was 171 cases(20.5%)and 106 cases(12.2%),respectively,with gestational age<32 weeks(833 cases)and≥32 weeks(867 cases).Compared with gestational age<32 weeks of premature infants,the incidence of ICH in≥32 weeks of premature infants was significantly reduced(P<0.05);3)The number of ICH was 136 cases(21.2%)and 141 cases(13.2%),respectively,with birth weight<1500 g(639 cases)and≥1500 g(1061 cases).Compared with birth weight<1500 g premature infants,the incidence of ICH in≥1500 g premature infants was significantly reduced(P<0.05).Conclusion Premature infants with low gestational age or birth weight have the higher incidence of ICH.Bedside ultrasound could provide reliable information on ICH in premature infants,which should be the preferred method for screening and monitoring ICH in premature infants.