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目的分析新生儿脑梗死的临床特征及预后。方法回顾性分析2012年4月至2013年3月我院新生儿科确诊为新生儿脑梗死的病例资料,总结临床特征,进行围产期因素和其他可能病因分析,并对存活患儿进行18~20个月的随访。结果 8例脑梗死患儿均为足月儿。缺血性梗死6例(75%),出血性梗死2例(25%)。围产期缺氧缺血是最常见的高危因素(占50%)。惊厥是新生儿脑梗死最常见的首发症状及病程中最多见的临床表现(占62.5%),其次为阵发性青紫、呼吸暂停及反应差。新生儿脑梗死最易累及大脑中动脉且右侧多见。新生儿脑梗死急性期以支持和对症治疗为主。预后不良的患儿中,梗死多累及深部灰质核团或波及多个脑叶。结论围产期缺氧是新生儿脑梗死常见的高危因素,惊厥是最常见的早期临床表现,梗死累及深部灰质或范围较广者可能预后不良。
Objective To analyze the clinical features and prognosis of neonatal cerebral infarction. Methods A retrospective analysis was performed on the data of cases diagnosed as neonatal cerebral infarction from April 2012 to March 2013 in our hospital. The clinical features were summarized and the perinatal and other possible causes were analyzed. 20 months follow-up. Results Eight children with cerebral infarction were full-term children. Six cases (75%) of ischemic infarction and two cases of hemorrhagic infarction (25%). Perinatal hypoxic-ischemic is the most common risk factors (50%). Convulsion is the most common first symptom and the most common clinical manifestation in neonatal cerebral infarction (62.5%), followed by paroxysmal cyanosis, apnea and poor response. Neonatal cerebral infarction most likely to involve the middle cerebral artery and more common on the right. Acute neonatal cerebral infarction to support and symptomatic treatment based. In children with poor prognosis, infarction involves more deep gray matter nuclei or multiple brain lobes. Conclusions Perinatal hypoxia is a common high risk factor for neonatal cerebral infarction. Convulsion is the most common early clinical manifestation. In patients with infarction involving deep gray matter or a wide range, the prognosis may be poor.