Saliba E, Bertrand P, Gold F, Marchand S, Laugier J
Institut de la Santé et de la Recherche Médicale (INSERM), Unité 316, Tours, France.
Arch Dis Child. 1990 Oct;65(10 Spec No):1033-7. doi: 10.1136/adc.65.10_spec_no.1033.
The association between measurements of lateral ventricle area (determined by serial ultrasound scans) and outcome was studied in 70 preterm neonates of 33 weeks' gestation or less. The study group was subdivided into four groups according to cranial ultrasonographic findings at 2 weeks postnatal age: group A (n = 15) had isolated periventricular/intraventricular haemorrhage; group B (n = 20) had periventricular/intraventricular haemorrhage and dilated ventricles; group C (n = 24) had periventricular/intraventricular haemorrhage and periventricular leukomalacia with or without dilated ventricles; and group D (n = 11) had isolated periventricular leukomalacia. Eighty seven preterm infants with no evidence of intracranial disease and good neurodevelopmental outcomes at 2 years formed the control group. A poor outcome was observed in infants in group B, C, and D, particularly in those who had persistent dilated ventricles at 6 weeks postnatal age and extensive periventricular leukomalacia. There was no difference in outcome between group A and controls. During the first six weeks of life ventricular area growth velocities were significantly higher in groups B, C, D, compared with normal controls and group A. We suggest that persistent ventricular dilatation at this early stage carries a bad prognosis, which is the result of atrophy of the brain.
在70名孕周33周及以下的早产新生儿中,研究了侧脑室面积测量值(通过系列超声扫描确定)与预后之间的关联。研究组根据出生后2周时的头颅超声检查结果分为四组:A组(n = 15)有孤立的脑室周围/脑室内出血;B组(n = 20)有脑室周围/脑室内出血且脑室扩张;C组(n = 24)有脑室周围/脑室内出血和脑室周围白质软化,伴或不伴有脑室扩张;D组(n = 11)有孤立的脑室周围白质软化。87名2岁时无颅内疾病证据且神经发育结局良好的早产婴儿组成对照组。观察到B组、C组和D组的婴儿预后较差,尤其是那些出生后6周时脑室持续扩张且有广泛脑室周围白质软化的婴儿。A组与对照组的预后无差异。在出生后的前六周,与正常对照组和A组相比,B组、C组、D组的脑室面积生长速度明显更高。我们认为,早期持续的脑室扩张预后不良,这是脑萎缩的结果。