<29 孕周伴出血后脑积水的早产儿行脑室-腹腔分流术后的长期神经发育和生长结局。
Long-Term Neurodevelopmental and Growth Outcomes of Premature Infants Born at <29 week Gestational Age with Post-Hemorrhagic Hydrocephalus Treated with Ventriculo-Peritoneal Shunt.
机构信息
Section of Neonatology, Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.
Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.
出版信息
Indian J Pediatr. 2017 Sep;84(9):662-669. doi: 10.1007/s12098-017-2319-z. Epub 2017 Apr 3.
OBJECTIVE
To compare long-term neurodevelopmental and growth (NDG) outcomes at 3 y corrected gestational age (GA) in premature infants with grade ≥ III intraventricular hemorrhage (IVH) and post-hemorrhagic hydrocephalus who were treated with ventriculo-peritoneal shunt with those who were not treated with shunt.
METHODS
In a retrospective cohort study, NDG outcomes were compared between preterm infants of <29 wk GA with IVH treated with shunt (IVHS) and IVH with no shunt (IVHNS). This was a single centre study. The primary outcome was moderate to severe cerebral palsy (CP).
RESULTS
Of 1762 preterm infants who survived to discharge, 90 had grade ≥ III IVH. Infants in IVHS group had more grade IV IVH than IVHNS (p < 0.05). Seventy percent of the patients in IVHNS groups had no hydrocephalus. IVHS group had increased CP (76% vs. 30%; p 0.003), and higher odds of CP after controlling for GA and IVH grade [odds ratio (OR); 4.23 (1.38 to 13.00)]. Growth delay was not different between groups.
CONCLUSIONS
Infants with IVHS are at increased risk of CP but not growth delay.
目的
比较伴有≥3 级脑室内出血（IVH）和出血后脑积水的早产儿在 3 校正胎龄（GA）时的长期神经发育和生长（NDG）结局，这些早产儿接受了脑室-腹腔分流术与未接受分流术的早产儿。
方法
在一项回顾性队列研究中，比较了接受分流术（IVHS）和未接受分流术（IVHNS）治疗的<29 周 GA 伴 IVH 的早产儿的 NDG 结局。这是一项单中心研究。主要结局是中重度脑瘫（CP）。
结果
在 1762 名存活至出院的早产儿中，90 名患有≥3 级 IVH。IVHS 组的婴儿比 IVHNS 组的 IVH 更严重（IVH 4 级）（p<0.05）。IVHNS 组 70%的患者无脑积水。IVHS 组 CP 发生率增加（76%比 30%；p<0.003），控制 GA 和 IVH 分级后 CP 的发生率更高[比值比（OR）；4.23（1.38 至 13.00）]。两组之间的生长迟缓没有差异。
结论
IVHS 患儿患 CP 的风险增加，但不会导致生长迟缓。
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