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新生儿自发性颅内出血的诊治要点及对心理、智力发育的影响

Diagnosis and treatment on neonates with spontaneous intracranial hemorrhage(SIH)and the effect on intelligence and psychological development

  • 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,并观察其心理与智力发育的情况。方法 选取2013年6月-2016年6月,广州市妇女儿童医疗中心收治的60例临床资料完整的新生儿自发性颅内出血患者进行回顾性分析,并比较其与正常新生儿的智能发育指数(MDI)与心理智力发育状况。结果 6例患儿诊断为先天性维生素K缺乏症,46例诊断为脑动静脉畸形,2例诊断为海绵状血管瘤,4例诊断为后交通动脉瘤,3例诊断为烟雾病,另有1例原因不明。经过治疗,48例痊愈,7例轻残,3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,差异有统计学意义(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。

     

    Abstract: Objective To explore the clinical features and treatment options of spontaneous intracranial hemorrhage in neonates and the effect of intelligence and psychological development.Methods The medical records and radiographic images of 60 neonates who were spontaneous intracranial hemorrhage and treated in our hospital from June 2013 to June 2016 were retrospectively analyzed,and their Mental development index(MDI) and psychological development were compared with normal neonates.Results 6 neonates were diagnosed with Vatime K deficiency,46 cases were diagnosed as cerebral arteriovenous malformation,2 cases were diagnosed as cavernous hemangioma,4 cases were diagnosed as posterior communicating artery aneurysm and 3 cases were diagnosed as moyamoya.After treating,48 cases were healed,10 cases were disabled and 2 cases were dead. The MDI and developmental quotient in neonates with spontaneous intracranial hemorrhage were lower than normal neonate after 12 months follow-up.Conclusions Neonatal intracranial hemorrhage can impact intelligence and psychological development. Blood coagulation,DSA,CT and MRI made great contribution for diagnosis,the clinician should take appropriate treatment options according to different causes of disease.

     

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