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目的着重从影像学角度探讨西宁地区(海拔2260 m)早产儿颅内出血(ICH)的CT特征及其与胎龄、出生体重、临床症状及转归的关系。资料与方法对540例早产儿中387例ICH的CT特征、临床资料进行回顾性分析。结果540例中387例ICH的检出率为71.7%,其中蛛网膜下腔出血(SAH)226例(58.4%),室管膜下-脑室内出血(SEH-IVH)124例(32.0%),脑实质出血(IPH)37例(9.6%);出生体重>1500 g、胎龄32～34周者多发生SAH,出生体重<1500 g、胎龄<32周者发生SHE-IVH较多;临床上有症状者324例(83.7%),其中以兴奋症状为主者103例,以抑制状态为主者170例,先短暂兴奋后转为抑制状态者51例;治愈及好转211例,死亡131例,自动出院45例,病死率33.9%。结论高海拔地区早产儿ICH发病率明显偏高(约71.7%),与高原缺氧关系密切,症状重,病死率高,CT检查具有重要的临床应用价值。
Objective To investigate the CT features of intracranial hemorrhage (ICH) in preterm infants in Xining (elevation 2260 m) and its relationship with gestational age, birth weight, clinical symptoms and prognosis from the imaging point of view. Materials and Methods The CT features and clinical data of 387 ICH patients in 540 preterm infants were analyzed retrospectively. Results The detection rate of ICH in 387 cases was 71.7% in 540 cases, of which 226 cases (58.4%) had subarachnoid hemorrhage (SAH), 124 cases (32.0%) had subependymetry-intraventricular hemorrhage (SEH-IVH) 37 cases (9.6%) had intracerebral hemorrhage (IPH), birth weight> 1500 g, SAH more than gestational age from 32 to 34 weeks, birth weight <1500 g, SHE-IVH more than 32 weeks gestational age There were 324 cases (83.7%) with symptomatic symptoms, of which 103 cases were mainly excitatory symptoms, 170 cases were mainly state of inhibition, and 51 cases were transient state of inhibition after being transiently excited; 211 cases were cured and improved, 131 For example, 45 cases were discharged automatically, the case fatality rate was 33.9%. Conclusion The incidence of ICH in preterm infants at high altitude is obviously high (about 71.7%), which is closely related to hypoxia on the plateau. The symptom is heavy and the mortality rate is high. CT examination has important clinical value.