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目的分析新生儿颅内出血(ICH)的发生特点及预后。方法对58例经头颅CT确诊的新生儿ICH的临床资料进行回顾性分析。结果 58例中蛛网膜下腔出血(SAH)43例(74.1%),其中40例合并新生儿缺氧缺血性脑病;4例硬膜下出血(SDH)均有难产史;32~34周早产儿6例均发生脑室内及室管膜下出血(IVH);脑实质出血(IPH)的CT表现与成人相似。IVH及IPH共11例,其中4例放弃治疗,2例死亡,5例头颅CT随访显示有脑积水、脑萎缩、空洞脑,临床表现为生长发育落后、惊厥、肌张力异常等神经系统症状。在出血类型相同的情况下,其出血量与临床表现轻重程度密切相关;5例SAH因出血量少,预后良好。早产儿ICH常缺乏特异性表现,临床上易误诊。结论 ICH是新生儿颅脑损伤的主要类型之一,也是主要死亡原因之一,宜早期发现、早期治疗,降低残疾率,提高生命质量。
Objective To analyze the characteristics and prognosis of neonatal intracranial hemorrhage (ICH). Methods The clinical data of 58 neonates with ICH confirmed by skull CT were retrospectively analyzed. Results 58 cases of subarachnoid hemorrhage (SAH) in 43 cases (74.1%), of which 40 cases of neonatal hypoxic-ischemic encephalopathy; 4 cases of subdural hemorrhage (SDH) have a history of dystocia; 32 to 34 weeks Six cases of premature infants both had intraventricular and subependymal hemorrhage (IVH); CT findings of intraparenchymal hemorrhage (IPH) were similar to those of adults. IVH and IPH in 11 cases, of which 4 patients give up treatment, 2 died, 5 cases of cranial CT follow-up showed hydrocephalus, brain atrophy, empty brain, the clinical manifestations of growth and development, convulsions, abnormal muscle tone and other neurological symptoms . In the same type of bleeding, the amount of bleeding is closely related to the severity of clinical manifestations; 5 cases of SAH due to less bleeding, the prognosis is good. ICH often lack of specific performance in preterm children, clinically misdiagnosed. Conclusion ICH is one of the main types of neonatal brain injury and one of the main causes of death. It is suggested that ICH should be detected and treated early to reduce the disability rate and improve the quality of life.