显示或下载PDF文件-早产儿脑室内出血的早期诊断和防治

:200092,,,,19981144,5187%[1],,2000,,(intraventricularhemorrhage,IVH),65%IVH[2],,IVH20%IVH,IVH,,,IVH,,[3](IVIVH,IVH),15%25%,59%,86%,64%IVH,BIVH,25%50%IVH,,3IVH,IVHIVH1518%(52/330)3%(10/330),7615%(13/17)3513%(6/17),[4],37dB,IVH,,IVHPapile[5]:;:,IVH;:IVH;:IVHBCTMRIIVH,XMRI,CTMRI,CT,1,B,BIVH[628]IVH,,,IVH;,,IVH13%70%,,CTMRI,BIVH,0137ml/min,,,,,,,,,IVH40%70%,1570d,,,,,()IVH2080[9,10],75%91%[11,12]01120032412ChinJPediatr,February2003,Vol41,No.2,,,,,,[2]BIVH,B,610mm,1115mm,15mmB:,,L45,,,,6h:(1):,,6d,2(2):,,,(3):,,810ml,14ml5ml()(4):1,2,,,,,B,,,,19881[13],[14,15]198919968412%16(1416517)d,(23141210)d,(913417),(311116)d,(617210)ml,(1011718)d16,12,4,1617IVH,4,4,5,4,,,,,,[16],,1030mg/(kgd),,,,,,,,[17],,,,IVH,,,,,,22,,,,,10,95%[18,19]IVH:34,6h20mg/kg,24h5mg/kg,45dDonn[20]19811800g6hIVH,IVH47%13%1982,1800gIVH[21,22],,,,,,,,IVH,,[23],IVH,DonnIVH8005,,IVH[24]11120032412ChinJPediatr,February2003,Vol41,No.2,,57IVH[25,26],IVHIVH,IVH,IVH4IVHIVH,2IVH,,IVH,,,IVH[27,28],Donn1800g6hIVH,IVH(20%),IVH,IVH,,IVH,IVH,,,,IVH[29,30]21,,,1..,2000,38:2712273.2..:,1995.124.3..,2000,15:7172719.4,,.IVH.,1998,21:69271.5PapileLA,BursteinR,etal.Incidenceandevaluationofsubependymalandintraventricularhemorrhage:astudyofinfantswithbirthweightlessthan1500g.JPediatr,1978,92:5292534.6,,,.CT.,1987,21:992101.7,,,.(BCT).,1989,7:2712273.8..,2001,24:11215.9PapileLA,BursteinJ,BursteinR,etal.Posthemorrhagichydrocephalusinlow2birth2weightinfants:treatmentbyseriallumbarpunctures.JPediatr,1980,97:2732277.10..,1987,1:23224.11HeepA,EngelskirchenR,HolschneiderA,etal.Primaryinterventionforposthemorrhagichydrocephalusinverylowbirthweightinfantsbyventriculostomy.ChildsNervSyst,2001,17:47251.12MullerW,UrlesbergerB,MaurerU,etal.Seriallumbartappingtopreventposthaemorrhagichydrocephalusafterintracranialhaemorrhageinpreterminfants.WienKlinWochenschr,1998,110:6312634.13,,,..,1990,28:50251.14,,,.LP8IVH.,1994,32:2132214.15,,,..,1999,19:1102113,116.16,,,.LPLP.,1995,10:3582359.17VentriculomegalyTrialGroup.Randomizedtrialofearlytappinginneonatalpost2haemorrhagicventriculardilatation.ArchDisChild,1990,65:3210.18HopfNT,GrunertP,FriesG,etal.Endoscopicthirdventriculostomy:outcomeanalysisof100consecutiveprocedures.Neurosurgery,1999,44:7952806.19,,,..,2002,23:2142215.20DonnSM,RoloffDW,GoldsteinGW.Preventionofintraventricularhemorrhageinpreterminfantsbyphenobarbitone.Acontrolledtrail.Lancet,1981,2:2152217.21ChenHJ,RoloffDW.RoutineadministrationofphenobarbitalforthepreventionofIVHinprematureinfants:5yearsexperience.JPerinatol,1994,14:15222.22ChenHJ,RoloffDW.DoseroutineuseofPbreducetheincidenceofIVHinprematureinfants?PediatrRes,1991,29:208A.23WimberleyPD,LouHC,PedersenH,etal.Hypertensivepeaksinthepathogenesisofintraventricularhemorrhageinthenewborn.Abolitionbyphenobarbitonesedation.ActaPediatrScand,1982,71:5372542.24.IVH.,1992,10:97.25,,,.IVH.,1996,34:1222124.26ChenHJ,WuSM,HuangP.PhenobarbitalforthepreventionofIVHinChineseprematureinfants2AcontrolledtrailinShanghai.JSSMU,1999,11:42244.27ThollDA,MillerTQ,HendersonWG,etal.Meta2analysisofphenobarbitalusageforpreventionofintraventricularhemorrhageinprematureinfants:factorsrelatedtovariationinoutcome.ClinTrialsMetaanal,1994,29:1772190.28WhitelawA.Postnatalphenobarbitoneforthepreventionofintraventricularhemorrhageinpreterminfants.CochraneDatabaseSystRev,2001,1:CD001691.29PerlmanJM,GoodmanS,KreusserKL,etal.Reductioninintraventricularhemorrhagebyeliminationoffluctuatingcerebralblood2flowvelocityinpreterminfantswithrespiratorydistresssyndrome.NEnglJMed,1985,312:135321357.30.IVH.,1992,10:97299.(:2002202211)(:)21120032412ChinJPediatr,February2003,Vol41,No.2