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目的分析新生儿肾上腺血肿的临床特点、诊治过程及预后,提高对新生儿肾上腺血肿的认识。方法回顾性分析本院新生儿中心2007年1月至2012年12月收治的新生儿肾上腺血肿患儿,总结出生情况、发现血肿时间、临床表现、实验室检查、临床处理及预后。结果研究期间共诊断肾上腺血肿77例,其中自然分娩68例(88.3%),72例(93.5%)出血发生在右侧,3例并发阴囊血肿。54例(70.1%)以高胆红素血症为主要表现,1例腹部体检扪及确切包块。随访中3例出现继发性肾上腺皮质功能减低,治疗后肾上腺功能皆恢复正常,1例确诊为成神经细胞瘤。结论肾上腺血肿出血量少的患儿可在新生儿期接受保守对症治疗,预后良好;中到大量出血需与肿瘤鉴别,并需监测肾上腺皮质功能。
Objective To analyze the clinical features, diagnosis, treatment and prognosis of neonatal adrenal hematoma and to improve the understanding of neonatal adrenal hematoma. Methods The neonatal adrenal hematomas from January 2007 to December 2012 in our hospital were retrospectively analyzed. The incidence of hematoma, the clinical manifestations, laboratory tests, clinical treatment and prognosis were summarized. Results A total of 77 adrenal hematomas were diagnosed during the study, of which 68 (88.3%) were spontaneous and 72 (93.5%) had hemorrhage on the right and 3 had scrotal hematoma. 54 cases (70.1%) with hyperbilirubinemia as the main performance, 1 abdominal palpable palpable and exact mass. Follow-up in 3 cases of secondary adrenal insufficiency, after treatment, adrenal function returned to normal, 1 case was diagnosed as neuroblastoma. Conclusions Children with small amount of bleeding in adrenal hematoma can receive conservative symptomatic treatment during the neonatal period with good prognosis. The moderate to large hemorrhage needs to be differentiated from the tumor and the adrenocortical function needs to be monitored.