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重度Rh溶血病患儿宫内输血后的发育情况(作者译)

[The development of children following intra-uterine transfusions in severe Rh-erythroblastosis (author's transl)].

作者信息

Schellong G, Palm D, Maier-Becker E M, Quakernack K

出版信息

Z Geburtshilfe Perinatol. 1977 Feb;181(1):36-45.

PMID:848077
Abstract

The development of 18 children who had received 1--3 intra-uterine transfusions (IUT) because of severe Rh-erythroblatosis was followed over the first few years of life and finally checked when they were 2--6 years old. All of them were premature, 2 were born with hydrops, 1 with pre-hydrops. There were many other perinatal riskfactors (asphyxia, trouble with respiration, acidosis, severe anemia, hyperbilirubinemia). Examination (general and neurologic) was supplemented by EEG and psychologic testing )Kramer test, Vineland maturity scale, Denver development scales). No child showed signs of severe cerebral damage. 2 children had unequivocal pathologic signs (slight to medium spastic diplegia or hemipegia with corresponding focal findings in EEG). 3 further children showed minimal cerebral signs without disability. Development of intelligence was notably good throughout. Observations showed abnormal neurologi-signs more often during the first 2 years of life than later. Psychologic examinations, too, showed clear improvement with age. Results are satisfactory and confirm that IUT as a prenatal treatment with very severe Rh-Erythroblastosis is justified.

摘要

对18名因严重Rh溶血病接受过1至3次宫内输血(IUT)的儿童在生命的最初几年进行了跟踪,并最终在他们2至6岁时进行了检查。他们均为早产儿,2例出生时患有水肿,1例出生时患有早期水肿。还有许多其他围产期危险因素(窒息、呼吸问题、酸中毒、严重贫血、高胆红素血症)。通过脑电图和心理测试(克莱默测试、文兰成熟量表、丹佛发育量表)辅助进行检查(全身和神经学检查)。没有儿童表现出严重脑损伤的迹象。2名儿童有明确的病理体征(轻度至中度痉挛性双侧瘫或偏瘫,脑电图有相应的局灶性表现)。另外3名儿童有轻微的脑部体征但无残疾。总体而言,智力发育明显良好。观察结果显示,在生命的头两年比之后更常出现异常神经体征。心理检查也显示随着年龄增长有明显改善。结果令人满意,证实宫内输血作为一种治疗非常严重的Rh溶血病的产前治疗方法是合理的。

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