目的了解早产儿脑损伤的发病率及影响因素。方法对288例早产儿于生后3～7天内常规进行头颅CT检查。对不同胎龄、出生体重早产儿脑损伤发生率、严重程度及损伤程度与并发症的关系等进行分析。结果180例早产儿存在脑损伤,总的脑损伤发生率62.5%(180/288)。其中,颅内出血发生率49.3%(143/288),其他依次为脑室周围-脑室内出血62例,蛛网膜下腔出血(SAH)59例,脑实质出血(IPH)12例,小脑出血(ICEH)10例。脑室周围白质软化37例(12.8%)。180例中有窒息史62例,其中,轻度52例,中重度10例。窒息程度与脑损伤程度密切相关。胎龄越小,体重越低,脑损伤发生率越高。并发症新生儿呼吸窘迫综合征(NRDS),肺出血,呼衰,呼吸暂停,低血糖,重症感染与脑损伤程度有关。结论早产儿脑损伤的发生及严重程度与多因素有关,临床表现常不典型,脑损伤易漏诊,头颅CT筛查是必要的,并为早期诊断及早期干预提供依据。 Objective To understand the incidence and influencing factors of brain injury in premature infants. Methods 288 preterm infants were examined by skull CT routinely within 3 to 7 days after birth. The incidence and severity of brain injury in different gestational age and birth weight preterm infants were analyzed. Results 180 cases of premature children had brain injury, the total incidence of brain injury was 62.5% (180/288). Among them, the incidence of intracranial hemorrhage was 49.3% (143/288), followed by ventriculo-ventricular hemorrhage in 62 cases, subarachnoid hemorrhage (SAH) in 59 cases, cerebral parenchymal hemorrhage (IPH) in 12 cases, cerebellar hemorrhage (ICEH) 10 cases. Periventricular white matter softening in 37 cases (12.8%). There were 62 cases of asphyxia in 180 cases, of which 52 were mild and 10 were moderate to severe. Degree of asphyxia and brain injury are closely related. The smaller the gestational age, the lower the body weight, the higher the incidence of brain injury. Complications Neonatal respiratory distress syndrome (NRDS), pulmonary hemorrhage, respiratory failure, apnea, hypoglycemia, and severe infections are related to the degree of brain injury. Conclusions The occurrence and severity of brain injury in preterm infants are related to many factors. The clinical manifestations are often not typical. Brain injury is easy to miss, skull CT screening is necessary, and provide the basis for early diagnosis and early intervention.