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目的探讨小儿颅内出血的早期诊断与急救措施,减少误诊及后遗症的发生。方法总结分析2003年4月至2009年2月因颅内出血收至儿童重症监护病房的重症患儿的临床资料。结果158例患儿中婴儿占84.8%(134/158),农村患儿占87.9%,迟发型维生素K缺乏症占颅内出血发病原因的首位(79.1%),年龄以不足3月龄的小婴儿为主,较大小儿以外伤与脑血管畸形、脑肿瘤为主;治愈87例,放弃治疗38例,转脑外科手术治疗10例,死亡21例(占13.3%)。治愈病例中于出院后6～12个月内定时复诊与随访44例,无任何后遗症23例;后遗症患儿21例,分别为癫痫9例,大脑发育不良3例,智力低下3例,瘫痪2例,单侧肢体轻度运动障碍2例,失明1例,智障和运动障碍1例。结论掌握不同年龄组临床发病特点并作出早期诊断,根据具体病情选择合适的治疗方法是降低本病病死率及致残率的关键。
Objective To explore the early diagnosis and emergency measures of intracranial hemorrhage in children and reduce the occurrence of misdiagnosis and sequelae. Methods The clinical data of severe children admitted to children’s intensive care unit from April 2003 to February 2009 due to intracranial hemorrhage were analyzed. Results Among the 158 infants, 84.8% (134/158) infants, 87.9% infants in rural areas, late onset vitamin K deficiency (79.1%), and infants less than 3 months old The main children were traumatic and cerebral vascular malformations and brain tumors. Among them, 87 were cured, 38 were given up, 10 were treated with brain surgery and 21 were died (13.3%). Among the cured cases, 44 cases were regularly referred and followed up within 6 to 12 months after discharge. There were 23 cases without any sequelae and 21 cases with sequelae, including 9 cases of epilepsy, 3 cases of poor brain development, 3 cases of mental retardation, 3 cases of paralysis Cases, unilateral limb mild dyskinesia in 2 cases, 1 case of blindness, mental retardation and dyskinesia in 1 case. Conclusion To grasp the clinical characteristics of different age groups and make early diagnosis, according to the specific condition to choose the appropriate treatment is to reduce the mortality and morbidity of the key.