Khanna G, Kapoor R K, Misra P K, Srivastava K L, Pant M C, Srivastava P K
Department of Pediatrics, K.G. Medical College, Lucknow.
Indian Pediatr. 1991 Nov;28(11):1283-8.
Twenty five asphyxiated newborns (seventeen term and eight preterm) with mean gestational age of 37 weeks (range 28-48 weeks) and mean birth weight of 2.4 kg (range 0.75 kg to 3.5 kg), respectively, constituted the cases in present study. Normal CT scan was found in five term (29.4%) and two preterm babies (25%). CT abnormalities noted in term babies included hemorrhage (subarachnoid 5.8%, intracerebral 11.6%), hypodensity (mild 23.2%, moderate 11.6% severe 5.8%); hypodensity with hemorrhage 5.8% and cerebral atrophy 5.8%. In the preterm babies abnormalities included intraventricular hemorrhage in 25%, isolated hypodensity in 37.5% and hypodensity with hemorrhage in 12.5% cases. Where as mild hypodensity on CT scan in the absence of hemorrhage or other gross abnormality was indicative of a favourable outcome, moderate to severe hypodensity was indicative of ischemic brain injury and an unfavourable outcome. The presence of intraventricular hemorrhage irrespective of the size of bleed was associated with mortality in all in the present study.
本研究中的病例包括25例窒息新生儿(17例足月儿和8例早产儿),平均胎龄37周(范围28 - 48周),平均出生体重2.4千克(范围0.75千克至3.5千克)。5例足月儿(29.4%)和2例早产儿(25%)CT扫描正常。足月儿中发现的CT异常包括出血(蛛网膜下腔出血5.8%,脑内出血11.6%)、低密度影(轻度23.2%,中度11.6%,重度5.8%);低密度影合并出血5.8%以及脑萎缩5.8%。早产儿的异常包括25%发生脑室内出血,37.5%出现单纯低密度影,12.5%出现低密度影合并出血。CT扫描显示无出血或其他明显异常的轻度低密度影提示预后良好,而中度至重度低密度影提示缺血性脑损伤及预后不良。在本研究中,无论出血量大小,脑室内出血的存在均与死亡相关。