摘要
目的 了解早产儿脑白质病变的类型、预后和发病的高危因素。 方法 通过影像学检查 ,观察了 64例早产儿脑室旁白质损伤的发生与转归 ,对这些患儿进行了远期智能发育水平的测评 ,并对可能导致早产儿脑或局部脑组织供氧供血障碍 ,造成脑室旁白质软化的围产期高危因素进行了分析 ,包括相关的母亲孕期合并症、新生儿早期疾病。 结果 本组早产儿脑室旁白质病变程度不同 :(1)脑室旁白质软化 18例 ,其中多灶性病变 6例 ,局灶性病变 12例。 (2 )脑室旁白质持续存在强回声 8例。 (3 )脑室旁白质一过性影像异常 3 8例。 46例随访结果显示 ,6例广泛性和 6例局灶性脑室旁白质软化病例中 ,DQ≤ 75的发生率分别为 10 0 %和 3 3 %。经Logistic多元逐步回归分析 ,本组病例中颅内出血伴脑室扩大与脑室旁白质病变的发生关系更为密切 ,母亲孕期合并症存在与否 ,在早产儿脑室旁白质病变的发生中差异有显著性。 结论 早产儿脑室旁白质损伤 ,尤其是脑室旁白质软化对小儿预后危害严重 ,多种围产期高危因素可导致发病 ,颅内出血伴脑室扩大是重要的发病因素。
ObjectiveTo recognize risk factors, types and prognosis of cerebral white matter injury i n preterm infants. MethodsThrough image examination, we obse rved the development of periventricular white matter injury in 64 preterm infant s. Follow-up was done to evaluate the mental development of them. We also anal yzed the perinaltal risk factors (maternal complications during pregnancy, and n eonatal diseases at early age) that related to periventricular leukomalacia (PVL ). Results Sixty-four preterm infants showed different d egrees of periventricular white matter injury: (1) Eighteen infants had PVL, of whom 6 had multi-site PVL, and 12 presented local PVL; (2) Eight infants had pe rsistent periventricular hyperecho; (3) Thirty-eight infants had transient abno rmality. Forty-six infants were followed up. The incidence of DQ≤75 was 100% a nd 33 33% in 6 infants with multi-site PVL and in 6 infants with local PVL res pectively. Logistic analysis showed that intraventricular hemorrhage (IVH) combi ned with expanded ventricle coorrelated with cerebral white matter injury. Babie s of mother who had pregnant complications had high incidence of PVL. ConclusionPeriventricular white matter injury, especially PVL is har mful in the prognosis of preterm infant. IVH combined with ventricular expansion is an important high risk factor of periventricular white matter injury.
出处
《中华围产医学杂志》
CAS
2003年第6期325-328,共4页
Chinese Journal of Perinatal Medicine
