四川医学
四川醫學
사천의학
Sichuan Medical Journal
2015年
8期
1065-1068
,共4页
冯艺%唐军%屈艺%母得志
馮藝%唐軍%屈藝%母得誌
풍예%당군%굴예%모득지
宫内感染%脑损伤%临床分析
宮內感染%腦損傷%臨床分析
궁내감염%뇌손상%림상분석
intrauterine infection%brain injury%clinical analysis
目的 探讨宫内感染类型及其与患儿脑损伤关系. 方法 回顾性分析我院2008年8月至2013年8月出院诊断先天性感染的122例病历资料,并随访患儿神经系统损伤表现,分析神经系统损伤发生概率及类型. 结果 122例中早产儿44例(36. 1%),低出生体重儿38例(31. 1%);单纯先天性梅毒感染69例(56. 6%)、病毒感染14例(11. 5%)、细菌感染11例(9. 0%),结核感染1例(0. 8%),混合感染18例(14. 7%),病原菌不明确9例(7. 4%). 50例有影像学检查中41例有异常改变,主要表现为颅内出血及脑实质密度减低. 共随访100例(随访率82. 0%) ,死亡24例( 24. 0%) ,平均随访时间(32. 0 ± 16. 7)个月,未见明显异常59例(59. 0%),发生神经系统后遗症17例(17%). 结论 先天性梅毒感染在宫内感染中占较大比例,宫内感染死亡率较高,大部分存活患儿未出现明显神经系统后遗症,部分存在明显语言、运动发育障碍、脑瘫、癫痫等表现,需定期随访神经系统发育情况,必要时早期康复治疗.
目的 探討宮內感染類型及其與患兒腦損傷關繫. 方法 迴顧性分析我院2008年8月至2013年8月齣院診斷先天性感染的122例病歷資料,併隨訪患兒神經繫統損傷錶現,分析神經繫統損傷髮生概率及類型. 結果 122例中早產兒44例(36. 1%),低齣生體重兒38例(31. 1%);單純先天性梅毒感染69例(56. 6%)、病毒感染14例(11. 5%)、細菌感染11例(9. 0%),結覈感染1例(0. 8%),混閤感染18例(14. 7%),病原菌不明確9例(7. 4%). 50例有影像學檢查中41例有異常改變,主要錶現為顱內齣血及腦實質密度減低. 共隨訪100例(隨訪率82. 0%) ,死亡24例( 24. 0%) ,平均隨訪時間(32. 0 ± 16. 7)箇月,未見明顯異常59例(59. 0%),髮生神經繫統後遺癥17例(17%). 結論 先天性梅毒感染在宮內感染中佔較大比例,宮內感染死亡率較高,大部分存活患兒未齣現明顯神經繫統後遺癥,部分存在明顯語言、運動髮育障礙、腦癱、癲癇等錶現,需定期隨訪神經繫統髮育情況,必要時早期康複治療.
목적 탐토궁내감염류형급기여환인뇌손상관계. 방법 회고성분석아원2008년8월지2013년8월출원진단선천성감염적122례병력자료,병수방환인신경계통손상표현,분석신경계통손상발생개솔급류형. 결과 122례중조산인44례(36. 1%),저출생체중인38례(31. 1%);단순선천성매독감염69례(56. 6%)、병독감염14례(11. 5%)、세균감염11례(9. 0%),결핵감염1례(0. 8%),혼합감염18례(14. 7%),병원균불명학9례(7. 4%). 50례유영상학검사중41례유이상개변,주요표현위로내출혈급뇌실질밀도감저. 공수방100례(수방솔82. 0%) ,사망24례( 24. 0%) ,평균수방시간(32. 0 ± 16. 7)개월,미견명현이상59례(59. 0%),발생신경계통후유증17례(17%). 결론 선천성매독감염재궁내감염중점교대비례,궁내감염사망솔교고,대부분존활환인미출현명현신경계통후유증,부분존재명현어언、운동발육장애、뇌탄、전간등표현,수정기수방신경계통발육정황,필요시조기강복치료.
Objective To explore the types of intrauterine infection and the brain injury in newborns. Methods A retro-spective analysis of 122 newborns diagnosed with congenital infection in our hospital from August 2008 to August 2013 was carried out. The neurological performance and injury was also analyzed in follow-ups. Results Among the 122 newborns, 44 (36. 1%) were preterm, and 38 ( 31. 1%) were low birth weight. Intrauterine infection was identified with simple congenital syphilis 69cases (56. 6%), viral infection 14 cases (11. 5%), other bacterial infection 11 cases (9. 0%), tuberculosis 1 case (0. 8%), combined infection in 18 cases(14. 7%), and unknown 9 cases (7. 4%). Lesion was found in 41 cases out of 50 chil-dren with B-ultrasound, CT, or MRI, which was mostly in the form of intracranial hemorrhage or parenchymal density secrease. 100 children (82. 0%) were followed up with a mean term of32. 0 ± 16. 7 months, including 59 (59. 0%) with no obvious abnor-malities,17(17%)with neurological sequelae, and 24 (24. 0%) died. Conclusion According to this clinical series, congenital syphilis is the most common type of intrauterine infection among newborns. The mortality rate of intrauterine infection is relatively high. No obvious neurological disorder is detected among the majority of surviving infants, but some sequence is also detected, such as language and/or motor develop disorders, cerebral palsy, epilepsy, and so on. Regular follow-up of nervous system devel-opment is needed and early rehabilitation is urgent in case.
