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目的分析新生儿脑梗死的临床特征及预后,提高对新生儿脑梗死的认识。方法选择2011年6月至2013年6月我院新生儿科收治的新生儿脑梗死患儿,总结新生儿脑梗死病例的临床特征,对围产期因素、临床表现、预后进行分析。结果研究期间共确诊9例新生儿脑梗死患儿,其中男7例,女2例;足月儿8例,早产儿1例;4例出现惊厥,5例临床表现无特异性。9例均经头颅磁共振及弥散加权成像检查确诊,脑梗死最易累及大脑中动脉,且左侧较右侧多见,3例合并颅内出血。1例住院1天放弃治疗死亡,共随访8例,4例随访至1~2岁,无神经系统异常;2例现分别3个月及5个月,仍定期随访中,暂无明显预后不良表现;2例随访至1.5岁,有神经系统后遗症。结论新生儿脑梗死临床症状不典型,对有惊厥和存在神经系统异常表现的患儿宜进一步进行颅脑核磁检查,积极治疗,指导康复。
Objective To analyze the clinical features and prognosis of neonatal cerebral infarction and to improve the understanding of neonatal cerebral infarction. Methods From June 2011 to June 2013 in our hospital neonates admitted to neonatal cerebral infarction in children, summarize the clinical features of neonatal cerebral infarction cases, perinatal factors, clinical manifestations, prognosis were analyzed. Results A total of 9 neonates with cerebral infarction were diagnosed during the study, including 7 males and 2 females; 8 full-term infants and 1 preterm infants; 4 convulsions and 5 nonspecific clinical manifestations. 9 cases were diagnosed by head magnetic resonance imaging and diffusion weighted imaging, cerebral infarction is most likely to involve the middle cerebral artery, and the left is more common than the right, 3 cases with intracranial hemorrhage. One patient was hospitalized to abandon treatment and died one day, a total of 8 cases were followed up, 4 cases were followed up to 1 to 2 years old, no neurological abnormalities; 2 cases were 3 months and 5 months, still regular follow-up, no obvious prognosis Performance; 2 cases were followed up to 1.5 years old, nervous system sequelae. Conclusions The clinical symptoms of neonatal cerebral infarction are not typical. Children with convulsion and abnormal nervous system should be further examined with craniocerebral magnetic resonance, active treatment and rehabilitation.