Abdel-Rahman A M, Rosenberg A A
Department of Pediatrics, University of Colorado School of Medicine, Denver.
Clin Perinatol. 1994 Sep;21(3):505-21.
PIVH remains a significant problem in the care of the preterm infant. Recent technologic advances such as real-time ultrasonography and Doppler flow studies have facilitated accurate diagnosis and provided insight into the pathogenesis. Although the overall incidence of PIVH is declining, the outcome of survivors of PIVH--especially those with more severe grades--remains unfavorable. Several antenatal and postnatal interventions aimed at reducing the overall incidence and severity of PIVH have been attempted. Antenatal interventions, in particular phenobarbital, appear to be promising because a substantial percentage of PIVH occurs in the immediate perinatal period. It is significant that the four reported antenatal phenobarbital trials demonstrated a consistent decrease in severe PIVH. Despite the fact that these studies have different designs and each must be considered on its own, the consistency of results makes a strong statement regarding efficacy and safety. The on-going multicenter Neonatal Network trial should provide definitive results as to the efficacy and safety of antenatal phenobarbital in the prevention of PIVH.
脑室周围-脑室内出血（PIVH）仍是早产儿护理中的一个重大问题。近期的技术进步，如实时光学超声和多普勒血流研究，有助于准确诊断并深入了解其发病机制。尽管PIVH的总体发病率在下降，但PIVH幸存者的预后——尤其是那些病情较严重的患儿——仍然不容乐观。人们已经尝试了几种旨在降低PIVH总体发病率和严重程度的产前和产后干预措施。产前干预措施，尤其是苯巴比妥，似乎很有前景，因为相当一部分PIVH发生在围产期即刻。值得注意的是，四项报道的产前苯巴比妥试验均表明重度PIVH持续减少。尽管这些研究设计不同，每项研究都必须单独考虑，但结果的一致性有力地证明了其有效性和安全性。正在进行的多中心新生儿网络试验应能就产前苯巴比妥预防PIVH的有效性和安全性提供明确结果。
