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新生儿脑室内出血的管理及并发症

Author
Lisa M Adcock, MD
Section Editors
Douglas R Nordli, Jr, MD
Joseph A Garcia-Prats, MD
Deputy Editor
Melanie S Kim, MD
Translators
张雨平, 副主任医师，副教授

引言

脑室内出血(Intraventricular hemorrhage, IVH)(又称作室管膜下出血)是早产婴儿脑损伤的重要病因。IVH对神经发育结局造成不良影响的原因不仅是IVH的直接后果，还有IVH的相关病变，如出血后脑积水和脑室周围白质软化。

虽然极低出生体重儿(very low birth weight, VLBW)(出生体重＜1500g)中IVH的发病率已经由20世纪70年代的高达40%-50%下降至2010年的20%-25%，但IVH患儿的绝对数仍然很高。这是因为早产儿的生存率提高，尤其是仍有IVH风险的超低出生体重儿(extremely low birth weight, ELBW)(出生体重＜1000g)人群[1,2]。 (参见“新生儿脑室内出血的临床表现和诊断”，关于‘流行病学’一节)

本专题将讨论早产新生儿IVH的预防、管理、并发症及结局。IVH的流行病学、发病机制、临床表现及诊断将单独讨论。 (参见“新生儿脑室内出血的临床表现和诊断”)

IVH严重程度和分级

IVH的严重程度基于头颅超声所显示的胚胎生发层基质和侧脑室的出血情况及出血量(表 1)：

●Ⅰ级：仅有胚胎生发层基质出血。

                    

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Literature review current through: 2017-06 . | This topic last updated: 2017-05-10.
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