Intraventricular haemorrhage and its prognosis, prevention and treatment in term infants
Intraventricular haemorrhage and its prognosis, prevention and treatment in term infants
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DOI：
10.1093/tropej/45.4.237
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发表时间：
1999-08-01
影响因子：
2
通讯作者：
Chituwo, BM
中科院分区：
文献类型：
--
作者：
Mao, CY;Guo, JW;Chituwo, BM
本研究旨在探讨足月儿脑室内出血（IVH）的预后及其预防和治疗。作者通过使用计算机断层扫描（CT）或颅超声检查（US）诊断足月新生儿的 IVH，对 CT 或 US 的结果进行审查，并由独立放射科医生使用 Papile 标准确定出血等级。所有婴儿在出生第一天由儿科医生进行检查，并判断为足月。儿童发育诊所的发育儿科医生使用格塞尔量表和标准神经系统检查对 2 至 10 岁的幸存者进行了检查，结果显示 36 名婴儿中的 3 名（8%）死亡； 17 名母亲（47%）出现妊娠并发症； 9 名女性血小板抗原 1 检测呈阴性，她们的婴儿表现出同种免疫性血小板减少症，诊断时年龄从子宫内到 28 天不等。临床表现包括喂养不耐受、烦躁、黄疸、发烧和烦躁不安。在 9 名 IV 级 IVH 儿童中，3 名死亡，6 名幸存者严重残疾。总体而言，33 名幸存者中有 22 人（67%）没有残疾或有轻微残疾。这项研究的结果表明，出血的严重程度具有预后价值，围产期同种免疫性血小板减少症被证明是严重出血和不良预后的最重要原因。如果我们要预防此类患者的 IVH 及其并发症，就必须在子宫内开始对这些婴儿进行识别和治疗。
The purpose of this study was to investigate the prognosis of intraventricular haemorrhage (IVH) in term infants and its prevention and treatment. The authors diagnosed IVH in full-term newborns by using computerized tomography (CT) or cranial ultrasonography (US), The results of CT or US were reviewed and the grade of haemorrhage was determined by an independent radiologist using Papile's criteria, All the infants were examined on the first day of their life by a paediatrician and judged to be full term. Survivors were examined between age 2 and 10 years at the Child Development Clinic by a Developmental Paediatrician using the Gesell scales and a standard neurologic examination, The results showed that three of 36 infants (8 per cent) died; complications of pregnancy were present in 17 mothers (47 per cent); nine women tested negative for platelet antigen 1 and their infants exhibited alloimmune thrombocytopenia, Age at diagnosis ranged from in utero to 28 days. Clinical presentation included feeding intolerance, irritability, jaundice, fever, and restlessness. Of the nine children with grade IV IVH, three died and six survivors were severely handicapped. Overall, 22 (67 per cent) of 33 survivors had no or mild handicap. The results of this study suggest that severity of haemorrhage was of prognostic value, Perinatal alloimmune thrombocytopenia turned out to be the single most important cause of severe haemorrhage and poor outcome. Identification and treatment of these infants must begin in utero if we are to prevent IVH and its complications in this group of patients.