脑梗死,新生儿,高危因素,惊厥,预后 ," /> 脑梗死,新生儿,高危因素,惊厥,预后 ,"/> Cerebral infarction,Neonate,High-risk factor,Convulsion,Prognosis ,"/> <div> <span style="line-height:2;font-size:14px;">足月新生儿脑梗死 18 例临床资料及</span><span style="line-height:2;font-size:14px;">预后分析</span> </div>
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发育医学电子杂志  2020, Vol. 8 Issue (4): 346-350    DOI: 10.3969/j.issn.2095-5340.2020.04.012
  围产医学   临床经验交流 |新生儿 |
足月新生儿脑梗死 18 例临床资料及预后分析
梅亚波 张娜 李秋平 封志纯
解放军总医院第七医学中心八一儿童医院  解放军总医院儿科医学部 出生缺陷防控关键技术国家工程实验室 儿童器官功能衰竭北京市重点实验室,北京 100700
Clinical data and prognosis analysis of 18 full-term neonates with cerebral infarction
Mei Yabo, Zhang Na, Li Qiuping, et al
BaYi Children’s Hospital, Seventh Medical Centerof Chinese PLA General Hospital; Department of Pediatrics, Chinese PLA General Hospital; NationalEngineering Laboratory for Birth defects prevention and control of key technology; Beijing Key Laboratoryof Pediatric Organ Failure, Beijing 100700, China
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摘要 
【摘要】 目的  探讨足月儿新生儿脑梗死(neonatal cerebral infarction,NCI)的可能病因、临床特点及预后。 方法 回顾性分析解放军总医院第七医学中心新生儿重症监护室 2008 年 6 月至 2018 年 6 月收治的 18 例足月 NCI 患儿的临床资料,分析其围产期高危因素、临床表现、影像学资料及 15 例患儿的随访结果。 结果  18 例 NCI 患儿均无明确窒息复苏史;4 例存在宫内窘迫史,其中 3 例为羊水型宫内窘迫(羊水Ⅲ度粪染);初产儿 13 例(72.2%)。惊厥是 NCI 患儿的主要临床表现(16/18,88.9%);生后惊厥出现时间主要集中在生后 72 h(16/18,88.9%),症状出现时间中位数为 24 h ;依据临床表现及头颅影像学检查可明确诊断,影像学检查提示脑梗死累及左侧大脑半球 10 例 (55.6%) ;18 例患儿中因放弃治疗失访 3 例,随访 15 例患儿中均未见智力发育障碍,5 例遗留运动发育障碍(其中 1 例存在运动障碍、语言障碍及癫痫,1 例合并语言发育障碍)。 结论 新生儿脑梗死病因复杂,目前尚无确切结论。惊厥是最常见的临床表现,多在生后不久起病。新生儿脑梗死可导致部分患儿远期出现运动、语言发育障碍,少数患儿可能出现癫痫发作。
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关键词:  脑梗死')" href="#">    
Abstract: 
【Abstract】 Objective To investigate the possible etiology, clinical features, and prognosis of cerebral
infarction in full-term neonates. Methods To retrospectively analyze the clinical data of 18 full-term
neonates with neonatal cerebral infarction (NCI) admitted to NICU of the Seventh Medical Center of
PLA General Hospital from June 2008 to June 2018, and analyze the perinatal high-risk factors, clinical
manifestations, imaging features and follow-up results of 15 infants. Results None of the 18 neonateswith NCI had a clear history of resuscitation. Four neonates had a history of intrauterine distress and 3 ofwhich belonging to amniotic flfluid type (severe meconium stained amniotic flfluid). Thirteen neonates (72.2%)were the baby of first production. Convulsion was the main clinical manifestation(16/18, 88.9%), and the timeof convulsion was mainly concentrated at 72 hours after birth (16/18, 88.9%). The median time of symptomonset in all 18 neonates was 24 h. The diagnosis was according to MRI/CT scan and clinical manifestations.MRI/CT scans showed that 10 cases (55.6%) of cerebral infarction involved the left cerebral hemisphere.Three infants were discontinued due to parental factors and were eventually lost to follow-up. None of theremaining 15 infants had intellectual developmental disorder, 5 infants of which had motor development
disorder(1 infant had motor defects, language disorder and epilepsy, and one infant combined with motor
defects of language disorder). Conclusions The etiology of NCI is complex, and with no definitive factor.
Convulsion is the most common clinical manifestation, most of which develop shortly after birth. NCI can
cause long-term motor defect, language development disorder of which, seizure may occur in a small number.
Key words:  Cerebral infarction')" href="#">
收稿日期:  2020-04-27                     发布日期:  2020-11-04     
基金资助: 
国家自然科学基金(81401248)
通讯作者:  封志纯https://baike.baidu.com/item/封志纯    E-mail:  fengzc81@sina.com
引用本文:    
梅亚波 张娜 李秋平 封志纯.
足月新生儿脑梗死 18 例临床资料及预后分析
[J]. 发育医学电子杂志, 2020, 8(4): 346-350.
Mei Yabo, Zhang Na, Li Qiuping, et al.
Clinical data and prognosis analysis of 18 full-term neonates with cerebral infarction
. Journal of Developmental Medicine(Electronic Version), 2020, 8(4): 346-350.
链接本文:  
http://www.fyyxzz.com/CN/10.3969/j.issn.2095-5340.2020.04.012  或          http://www.fyyxzz.com/CN/Y2020/V8/I4/346
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