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59例婴儿猝死的临床及解剖病理学研究

[Clinical and anatomo-pathologic study of 59 cases of sudden infant death].

作者信息

Dehan M, Imbert M C, Gautier J P, Benisvy C, Roset F, Magny J F, Saby M A, Dworzak P, Guyot H, Chabernaud J L

机构信息

Service de Réanimation Néonatale, Hôpital Antoine-Béclère.

出版信息

Arch Fr Pediatr. 1988 Oct;45(8):541-8.

PMID:3214247
Abstract

A proper organization has been set up at Antoine-Béclère's hospital in order to study the infants who died suddenly. Between July 1985 and July 1987, 69 cases (10 babies less than 1 week of age) were admitted. The purpose of this work was, for the 59 sudden deaths of infants aged more than 1 week (35 males, 24 females), to present the results of a definite protocol of investigation (past history, clinical examination, laboratory and pathological data) for determining either the etiology or the mechanism of these deaths. A thorough investigation was performed in 45/52 cases (no autopsy in 7 cases). A definite diagnosis was possible in 38/45: 13 viral infections, 5 gastro-esophageal reflux, 13 viral infections associated with reflux, 9 with an additional event (massive alimentary inhalation, slipping under blankets, major hyperthermia) to either a viral infection or a reflux, 1 cardiac malformation, 1 metabolic disorder, 2 accidents and 1 infanticide. With this protocol, 7/45 deaths remained unexplained. This medical approach of the problem of sudden deaths in infants is beneficial to the counselling of the parents and to the management of subsequent children.

摘要

安托万 - 贝克莱尔医院已设立了一个专门机构来研究猝死婴儿。在1985年7月至1987年7月期间,共收治了69例(其中10例为1周龄以下婴儿)。这项工作的目的是,针对59例1周龄以上婴儿的猝死病例(35例男性,24例女性),展示一套明确的调查方案(既往史、临床检查、实验室和病理数据)的结果,以确定这些死亡的病因或机制。在52例病例中,对45例进行了全面调查(7例未进行尸检)。在45例中的38例中做出了明确诊断:13例为病毒感染,5例为胃食管反流,13例为与反流相关的病毒感染,9例在病毒感染或反流基础上合并其他事件(大量食物吸入、被毯子捂住、严重体温过高),1例为心脏畸形,1例为代谢紊乱,2例为意外事故,1例为杀婴。按照该方案,45例中有7例死亡原因不明。这种针对婴儿猝死问题的医学方法有助于为家长提供咨询,并对后续婴儿的管理提供帮助。

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