新生儿自发性颅内出血的诊治要点(1)
【摘要】 目的：探讨新生儿自发性颅内出血的诊断方法、临床特点与治疗方法，并观察其心理与智能发育的影响。方法：选取2009年6月-2014年6月本院收治的32例自发性颅内出血患儿及32例正常新生儿的临床资料进行回顾性分析，并比较其与正常新生儿的智能发育指数(MDI)与心理发育状况。结果：3例患儿诊断为先天性维生素K缺乏症，23例诊断为脑动静脉畸形，1例诊断为海绵状血管瘤，2例诊断为后交通动脉瘤，2例诊断为烟雾病，另有1例原因不明。經过治疗，24例痊愈，4例轻残，2例中残，2例死亡。随访至12个月，自发性颅内出血新生儿MDI指数与发育商均低于正常新生儿，比较差异均有统计学意义(P<0.05)。结论：新生儿颅内出血可导致其心理与智能发育不良，而凝血功能、DSA、CT、MRI对其诊断有重要意义，医生应根据情况选取合适治疗方法，尽早诊治。
【关键词】 新生儿； 自发性颅内出血； 诊断； 治疗； 心理发育； 智能发育
Exploration on Diagnosis and Treatment with Spontaneous Intracranial Hemorrhage(SIH) in Neonates/MA Qin.//Medical Innovation of China，2016，13(31)：116-119
【Abstract】 Objective：To explore the clinical features and treatment options of spontaneous intracranial hemorrhage in neonates and the affect of intelligence and psychological development.Method：32 neonates of spontaneous intracranial hemorrhage and 32 normal neonates from June 2009 to June 2014 in our hospital were retrospectively analyzed，their mental development index (MDI) and psychological development were compared.Result：3 neonates were diagnosed with Vatime K defict，23 cases were cerebral arteriovenous malformation，1 case was cavernous hemangioma，2 cases were posterior communicating artery aneurysm and 2 cases were moyamoya.After treatment，24 cases were healed，4 cases of mild disability， 2 cases of medium disability，and 2 cases were dead.The MDI and developmental quotient were lower than normal neonate after 12 months follow-up，the differences were statistically significant(P<0.05).Conclusion：Neonatal intracranial hemorrhage can impact intelligence and psychological development.Blood coagulation，DSA， CT and MRI make great contribution for diagnosis，the clinician should take appropriate treatment options according to different cause of disease.
【Key words】 Neonates； Spontaneous intracerebral hemorrhage； Diagnosis； Treatment； Intelligence development； Psychological development
First-author’s address：Guangning People Hospital in Zhaoqing City，Zhaoqing 526300，China
doi：10.3969/j.issn.1674-4985.2016.31.034
新生儿自发性颅内出血起病快，临床表现不典型，若诊疗不及时，常预后极差，甚至造成新生儿的残疾与死亡。只有掌握其临床特点，及时发现，尽早诊断，正确治疗才能得到较好的临床效果。本文选取2009年6月-2014年6月本院收治的32例临床资料齐全的新生儿，对该疾病的诊治要点进行回顾性总结，并分析其对心理、智能发育的影响，现报道如下。
1 资料与方法
1.1 一般资料 选取2009年6月-2014年6月本院收治的32例临床资料齐全的新生儿自发性颅内出血患者作为观察组，另取同时期本院产科32例临床资料齐全的足月正常新生儿作为对照组。其中观察组32例患儿中男19例，女13例；日龄8～18 d，平均(13.4±3.1)d；体重范围1.95～2.74 kg，平均(2.31±0.30)kg。对照组32例正常新生儿中男16例，女16例；日龄9～17 d，平均(13.8±2.9)d，体重范围1.91～3.10 kg，平均(2.45±0.20)kg。(1)纳入标准：①患儿各种反射消失，有呼之不应现象发生；②血常规见血小板与血红蛋白降低；③影像学检查显示头部有出血病灶。(2)排除标准：①有严重外伤需急诊手术者；②有癫痫病史，无法主动配合治疗者；③合并有二尖瓣狭窄等先天性心脏病者。所有患者均签署知情同意书，并经医院伦理委员会审批。两组新生儿在性别、日龄与出生体重等一般资料比较差异均无统计学意义(P<0.05)，具有可比性。, 百拇医药(马勤)
【关键词】 新生儿； 自发性颅内出血； 诊断； 治疗； 心理发育； 智能发育
Exploration on Diagnosis and Treatment with Spontaneous Intracranial Hemorrhage(SIH) in Neonates/MA Qin.//Medical Innovation of China，2016，13(31)：116-119
【Abstract】 Objective：To explore the clinical features and treatment options of spontaneous intracranial hemorrhage in neonates and the affect of intelligence and psychological development.Method：32 neonates of spontaneous intracranial hemorrhage and 32 normal neonates from June 2009 to June 2014 in our hospital were retrospectively analyzed，their mental development index (MDI) and psychological development were compared.Result：3 neonates were diagnosed with Vatime K defict，23 cases were cerebral arteriovenous malformation，1 case was cavernous hemangioma，2 cases were posterior communicating artery aneurysm and 2 cases were moyamoya.After treatment，24 cases were healed，4 cases of mild disability， 2 cases of medium disability，and 2 cases were dead.The MDI and developmental quotient were lower than normal neonate after 12 months follow-up，the differences were statistically significant(P<0.05).Conclusion：Neonatal intracranial hemorrhage can impact intelligence and psychological development.Blood coagulation，DSA， CT and MRI make great contribution for diagnosis，the clinician should take appropriate treatment options according to different cause of disease.
【Key words】 Neonates； Spontaneous intracerebral hemorrhage； Diagnosis； Treatment； Intelligence development； Psychological development
First-author’s address：Guangning People Hospital in Zhaoqing City，Zhaoqing 526300，China
doi：10.3969/j.issn.1674-4985.2016.31.034
新生儿自发性颅内出血起病快，临床表现不典型，若诊疗不及时，常预后极差，甚至造成新生儿的残疾与死亡。只有掌握其临床特点，及时发现，尽早诊断，正确治疗才能得到较好的临床效果。本文选取2009年6月-2014年6月本院收治的32例临床资料齐全的新生儿，对该疾病的诊治要点进行回顾性总结，并分析其对心理、智能发育的影响，现报道如下。
1 资料与方法
1.1 一般资料 选取2009年6月-2014年6月本院收治的32例临床资料齐全的新生儿自发性颅内出血患者作为观察组，另取同时期本院产科32例临床资料齐全的足月正常新生儿作为对照组。其中观察组32例患儿中男19例，女13例；日龄8～18 d，平均(13.4±3.1)d；体重范围1.95～2.74 kg，平均(2.31±0.30)kg。对照组32例正常新生儿中男16例，女16例；日龄9～17 d，平均(13.8±2.9)d，体重范围1.91～3.10 kg，平均(2.45±0.20)kg。(1)纳入标准：①患儿各种反射消失，有呼之不应现象发生；②血常规见血小板与血红蛋白降低；③影像学检查显示头部有出血病灶。(2)排除标准：①有严重外伤需急诊手术者；②有癫痫病史，无法主动配合治疗者；③合并有二尖瓣狭窄等先天性心脏病者。所有患者均签署知情同意书，并经医院伦理委员会审批。两组新生儿在性别、日龄与出生体重等一般资料比较差异均无统计学意义(P<0.05)，具有可比性。, 百拇医药(马勤)