CAJ | 학술논문

随着早产儿抢救成功率的日益提高，经抢救成活后的早产儿生命质量愈来愈受到围生医学界和社会的关注，其中脑损伤是影响早产儿远期愈后的主要因素之一。造成脑损伤的危险因素主要有出生时胎龄和体质量、宫内缺氧和感染、分娩方式的选择及后期复苏治疗技术方法是否恰当和熟练等。尽可能地避免早产和尽量延长胎龄是防治脑损伤的根本。当早产不可避免，应及时应用肾上腺皮质激素促进胎儿肺成熟，皮质激素在产前应用的增多和产后应用的减少，在神经系统远期预后中已显现出了良好的效果。产前硫酸镁的应用在预防脑损伤效果上也得到了证实。在超低出生体质量儿分娩方式的选择与脑损伤的关系上尚未取得一致的意见，但产程的延长会增加早产儿颅内出血发生的概率，从而影响远期预后。在早产儿分娩后，执行正确的复苏流程，技术方法应用的熟练和恰当与近期病死率和远期预后密切相关。
수착조산인창구성공솔적일익제고，경창구성활후적조산인생명질량유래유수도위생의학계화사회적관주，기중뇌손상시영향조산인원기유후적주요인소지일。조성뇌손상적위험인소주요유출생시태령화체질량、궁내결양화감염、분면방식적선택급후기복소치료기술방법시부흡당화숙련등。진가능지피면조산화진량연장태령시방치뇌손상적근본。당조산불가피면，응급시응용신상선피질격소촉진태인폐성숙，피질격소재산전응용적증다화산후응용적감소，재신경계통원기예후중이현현출료량호적효과。산전류산미적응용재예방뇌손상효과상야득도료증실。재초저출생체질량인분면방식적선택여뇌손상적관계상상미취득일치적의견，단산정적연장회증가조산인로내출혈발생적개솔，종이영향원기예후。재조산인분면후，집행정학적복소류정，기술방법응용적숙련화흡당여근기병사솔화원기예후밀절상관。
Life quality of the premature babies after rescuing successfully was gained more attention by perina-tal medical field and society with the more success rate of premature rescue. The brain injury is one of the main factors affecting the long term prognosis of the premature infants. The major risk factors of brain damage include gestational age and birth weight,intrauterine hypoxia and infection,the mode of delivery and whether the resuscitation and later treat-ment skills proper and skilled,and so on. So the key point of preventing the brain injury is avoiding premature delivery and extending the gestational age as much as possible. If the premature delivery could not evitable,the obstetrician should use adrenal cortex hormones before delivery to promote fetal lungs maturition,since the increasing application of cortical hormone prenatally and decreasing using that after birth have been shown good effects on long term prognosis of the nervous system in the preterm infants. It is also confirmed that application of magnesium sulfate prenatally could prevent the premature brain injury. There are still no agreements on the relationship between the delivery modes and the brain injury of extremely low birth weight infants. But prolonging the stage of labor is sure to increase the incidence of intracranial hemorrhage in the premature infants thereby affecting the long term prognosis. After birth,we should imple-ment the correct resuscitation processes by skilled and proper technical methods,in order to decrease the mortality and to improve the long term prognosis.