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早产儿脑室周围短暂性回声增强与神经发育结局

Transient periventricular echodensities in preterms and neurodevelopmental outcome.

作者信息

Pisani Francesco, Leali Luisa, Moretti Sabrina, Turco Emanuela, Volante Enrico, Bevilacqua Giulio

机构信息

Department of Pediatrics, Unit of Child Neuropsychiatry, University of Parma, Parma, Italy.

出版信息

J Child Neurol. 2006 Mar;21(3):230-5. doi: 10.2310/7010.2006.00059.

Abstract

Little is known about the clinical evolution and neurologic sequelae of transient periventricular echodensities in the neonatal period. The aim of our study was to assess the neurodevelopmental outcome in preterm infants with transient periventricular echodensities. Cerebral ultrasonography was performed within the first 72 hours of life on all preterms with a < or = 37 weeks' gestational age who were admitted consecutively to the Neonatal Intensive Care Unit of the University of Parma from January 2001 to December 2002. Cerebral ultrasonography was performed at least twice within the 14th postnatal day and was repeated weekly until 40 weeks' postconceptional age. Transient aspecific echodensities were defined as areas in the periventricular region brighter than the choroid plexus persisting less than 14 days. One hundred sixty-four preterm infants were selected and divided into three groups: (1) 78 preterm infants without ultrasound abnormalities, (2) 50 preterm infants with transient periventricular echodensities, and (3) 36 preterm infants with persistent echodensities. Developmental outcome was assessed at 44 weeks' postconceptional age, after 1 month from the discharge and at the corrected ages of 3, 6, 9, and 12 months using the Griffiths Mental Developmental Scale. Group 1 and 2 infants showed normal neurodevelopment in 88.5% and 94% of cases, respectively, whereas the preterm infants belonging to group 3 had a favorable outcome in 22.2% (P < .001) of cases only. In conclusion, our study demonstrates how infants with transient echodensities show a neurodevelopmental outcome that is entirely identical to infants with a steadily negative ultrasound finding.

摘要

关于新生儿期短暂性脑室周围回声增强的临床演变及神经后遗症,人们了解甚少。我们研究的目的是评估患有短暂性脑室周围回声增强的早产儿的神经发育结局。对2001年1月至2002年12月连续入住帕尔马大学新生儿重症监护病房、胎龄≤37周的所有早产儿在出生后72小时内进行了脑部超声检查。在出生后第14天内至少进行两次脑部超声检查,并每周重复检查一次,直至孕龄40周。短暂性非特异性回声增强被定义为脑室周围区域比脉络丛更亮且持续时间少于14天的区域。选择了164名早产儿并将其分为三组:(1)78名无超声异常的早产儿,(2)50名有短暂性脑室周围回声增强的早产儿,(3)36名有持续性回声增强的早产儿。在孕龄44周、出院后1个月以及矫正年龄3、6、9和12个月时,使用格里菲斯心理发育量表评估发育结局。第1组和第2组婴儿分别在88.5%和94%的病例中表现出正常的神经发育,而第3组的早产儿仅在22.2%(P<0.001)的病例中有良好结局。总之,我们的研究表明,有短暂性回声增强的婴儿的神经发育结局与超声检查结果持续为阴性的婴儿完全相同。

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