中国当代儿科杂志2003,Vol.5Issue(5):407-411,5.
连续腰穿治疗新生儿重度脑室内出血的疗效评估
Effects of Serial Lumbar Puncture on Severe Intraventricular Hemorrhage of Neonates
钱继红 1陈惠金 1黄锦铃 1陈冠仪 1朱晓东 1储淞雯1
作者信息
- 1. 上海第二医科大学附属新华医院儿内科,上海,200092
- 折叠
摘要
Abstract
Objective Hydrocephalus is one of the most common complications of neonatal intraventricular hemorrhage (IVH). In this study, the effect of serial lumbar puncture (LP) on severe neonatal IVH is evaluated. Methods The effects of serial LP on 30 neonates hospitalized with severe IVH at Xinhua hospital since 1993 was evaluated. Another 30 neonates with severe IVH who had not been treated for preventing post-IVH hydrocephalus were used as the control group. Results Of the 30 cases which received serial LP therapy, the cerebral ventricles of 25 cases stopped enlarging and shrank distinctly. The effective rate was 83.3%. The average age when serial LP therapy initiated was (15.0±13.5) days, the average treatment course was (16.9±12.9) days. The serial LP therapy was repeated (6.4±4.7) times. The avarage interval of LP was (2.9±2.7) days and the average CSF volume removed was (6.7±1.6) ml. The average time of LP taking effect was (9.6±5.5) days. Ten cases received diamox treatment during the course of serial LP. After 1-2 weeks' combined treatment, the enlarged ventricles of 8 cases returned to normal or remained steady. Eighteen of 25 ases were followed-up for (8.3±1.9) months. Their physical and mental development were normal. Cranialcerebral ultrasound examination found that the shapes of cerebral ventricles of 14 cases were normal and the cerebral ventricles of another 4 cases enlarged slightly. The treatment with removed CSF >5 ml/time or with a shorter interval of LP (<2 d) acheived better effect (P<0.05 or 0.01). In the control group, the cerebral ventricles of 23 cases enlarged moderately or severely (6 of them complicated with hydrocephalus). Conclusions Serial LP is a safe and effective method for severe neonatal IVH in preventing post-IVH hydrocephalus.关键词
脑室内出血/连续腰穿/脑积水/新生儿Key words
Intraventricular hemorrhage/Serial lumbar puncture/Hydrocephalus/Newborn分类
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钱继红,陈惠金,黄锦铃,陈冠仪,朱晓东,储淞雯..连续腰穿治疗新生儿重度脑室内出血的疗效评估[J].中国当代儿科杂志,2003,5(5):407-411,5.