切换至 "中华医学电子期刊资源库"

中华妇幼临床医学杂志(电子版) ›› 2025, Vol. 21 ›› Issue (01) : 1 -14. doi: 10.3877/cma.j.issn.1673-5250.2025.01.001

标准·方案·指南

早产儿脑室内出血预防专家共识(2025)
中国医师协会新生儿科医师分会, 北京医师协会新生儿科医师分会, 李秋平1,(), 封志纯1,(), 母得志2,(), 唐军2, 熊涛2, 唐尚鸿1   
  1. 1. 中国人民解放军总医院第七医学中心儿科医学部,北京 100700
    2. 四川大学华西第二医院儿科、出生缺陷与相关妇儿疾病教育部重点实验室,成都 610041
  • 收稿日期:2024-09-30 修回日期:2025-01-12 出版日期:2025-02-01
  • 通信作者: 李秋平, 封志纯, 母得志
  • 基金资助:
    国家重点研发计划项目(2021YFC2700700、2021YFC2700702)

Expert consensus on prevention of intraventricular hemorrhage in preterm infants(2025)

Physicians Branch of Chinese Medical Doctor Association Neonatal, Branch of Beijing Medical Doctor Association Neonatologist, Qiuping Li1,(), Zhichun Feng1,(), Dezhi Mu2,(), Jun Tang2, Tao Xiong2, Shanghong Tang1   

  1. 1. Faculty of Pediatrics,Seventh Medical Center of Chinese PLA General Hospital,Beijing 100700,China
    2. Department of Pediatrics,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University),West China Second University Hospital,Sichuan University,Chengdu 610041,Sichuan Province,China
  • Received:2024-09-30 Revised:2025-01-12 Published:2025-02-01
  • Corresponding author: Qiuping Li, Zhichun Feng, Dezhi Mu
引用本文:

中国医师协会新生儿科医师分会, 北京医师协会新生儿科医师分会, 李秋平, 封志纯, 母得志, 唐军, 熊涛, 唐尚鸿. 早产儿脑室内出血预防专家共识(2025)[J/OL]. 中华妇幼临床医学杂志(电子版), 2025, 21(01): 1-14.

Physicians Branch of Chinese Medical Doctor Association Neonatal, Branch of Beijing Medical Doctor Association Neonatologist, Qiuping Li, Zhichun Feng, Dezhi Mu, Jun Tang, Tao Xiong, Shanghong Tang. Expert consensus on prevention of intraventricular hemorrhage in preterm infants(2025)[J/OL]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2025, 21(01): 1-14.

早产儿脑室内出血(IVH)是导致早产儿,特别是出生胎龄<32周早产儿死亡和严重神经系统残疾的重要合并症。近年我国早产儿救治数量大幅增加,极早产儿(出生胎龄≥28~31周)/超早产儿(出生胎龄<28周)的存活率也有很大提升,但是超早产儿的IVH 发生率高达48%,而且重度IVH 发生率呈逐年上升趋势,显著高于发达国家水平,值得临床高度关注。目前,国内尚无早产儿IVH 预防的专家共识或指南,故中国医师协会新生儿科医师分会、北京医师协会新生儿专科医师分会组织专家,在参考国内外相关研究进展和诊疗指南基础上,制定《早产儿脑室内出血预防专家共识(2025)/ExpertConsensusonPreventionofIntraventricularHemorrhageinPretermInfants2025)》(以下简称为本共识),以规范早产儿IVH 的预防和临床管理,从而降低早产儿IVH 发生率,改善早产儿近、远期神经系统发育结局。

Intraventricular hemorrhage(IVH)in preterm infants is a significant complication leading to mortality and severe neurological disabilities,particularly in preterm infants with a gestational age<32 weeks.In recent years,the number of preterm infants receiving medical treatment in China has significantly increased,and the survival rates of very preterm infants(gestational age ≥28-31 weeks)/extremely preterm infants (gestational age<28 weeks)have greatly improved.However,the incidence of IVH in extremely preterm infants remains high at 48%,with the occurrence of severe IVH showing an annual upward trend,markedly higher than that in developed countries,garnering significant attention.Currently,there is no expert consensus or guideline for the prevention of IVH in preterm infants within China.Therefore,the Neonatologist Branch of the Chinese Medical Doctor Association and the Neonatologist Branch of the Beijing Medical Doctor Association have organized experts to develop ExpertConsensusonPreventionof IntraventricularHemorrhageinPretermInfants2025)(hereinafter referred to as ThisConsensus).These initiatives in ThisConsensus is based on reference to relevant research progress and clinical guidelines both domestically and internationally,aiming to further standardize the prevention and clinical management of IVH in preterm infants,reduce the incidence of IVH,and improve both shortterm and long-term neurological development outcomes for preterm infants.

表1 采用GRADE系统对本研究早产儿IVH 早期预防的证据质量与推荐强度的分级标准
表2 早产儿IVH 分级标准的Papile分级标准与Volpe分级标准比较
表3 预防早产儿IVH 的集束化护理操作
续表4
编号 共识意见 证据等级 推荐强度
1 早产儿IVH 的发生机制复杂,与早产儿脑发育特点、宫内感染、脑血流波动、颅内压变化等多种因素相关,需注重早产儿产前、产时和产后全过程的精细化管理,以预防早产儿IVH 的发生 GPS -
2 推荐床旁颅脑超声作为早产儿IVH 的首要临床诊断手段 GPS -
3 对于临床状况稳定且无明显脑损伤临床症状的早产儿,建议在出生后4~7 d进行首次头颅超声检查。后续头颅超声检查的频率,需综合首次检查结果以及早产儿病情的稳定性进行评估后确定。对于首次头颅超声检查结果正常,且病情持续稳定、无脑损伤临床症状的早产儿,不推荐过高频率(>1次/周)的头颅超声复查
编号 共识意见 证据等级 推荐强度
4 对孕龄<35孕周孕妇,有早产风险时,产前对孕妇采取足疗程ACS治疗措施,可有效降低早产儿IVH 发生率
5 孕龄<34孕周孕妇早产临产,或择期剖宫产术分娩在即,早期(最好在分娩前4 h内)对孕妇采取硫酸镁治疗,有利于早产儿神经系统保护,并降低其IVH 发生风险
6 在分娩方式上,虽然尚无足够证据支持为降低IVH 发生率而对早产儿常规采取剖宫产术,但对于胎龄<32周臀位胎儿,推荐首选剖宫产术
7 建议将孕龄<32孕周有早产风险孕妇转运至3级围产中心分娩,以降低早产儿因出生后早期转运而增加的IVH 风险
8 对于不需要复苏的早产儿,建议分娩时对其采取DCC策略,有利于提高早产儿血容量,降低IVH 发生风险
9 对较大胎龄早产儿,单次或多次向婴儿侧UCM 可能有益,但对超早产儿,UCM 对脑血流影响较大,可能增加IVH 风险,不建议常规实施
10 务必高度重视早产儿的产房保暖,以及呼吸支持时的气道加温、加湿,这些措施都有助于降低早产儿IVH发生风险
11 对于出生胎龄≥25周且自主呼吸良好的早产儿,可优先考虑无创通气支持;对于需要有创通气治疗的早产儿,建议采用容量目标通气的保护性通气策略
12 应当规范早产儿输血操作,减少早期因非必要的不当输血而引发的IVH 风险
13 不推荐对早产儿常规使用非甾体类药物预防IVH 发生
14 不推荐使用苯巴比妥钠预防早产儿IVH 发生
15 不推荐使用EPO预防早产儿IVH 发生
16 对于生后早期出现低血压的早产儿,需注意鉴别是否为正常宫内外切换过程中的允许性低血压。应谨慎进行扩容及使用血管活性药物,避免增加早产儿IVH 发生风险
17 不建议常规使用止血药预防早产儿IVH。不过,对于存在凝血功能紊乱或相关高危因素的早产儿,可考虑使用酚磺乙胺来降低其IVH 发生风险
18 建议对早产儿在生后早期采取集束化护理措施,以降低其IVH 发生风险,具体措施包括将头部置于中线位置、抬高温箱前头部 15°~30°、对干扰较大的重要处置采用双人操作,以及避免换尿布时抬高臀部等
[30]
Committee opinion No.652:magnesium sulfate use in obstetrics[J].Obstet Gynecol,2016,127(1):e52-e53.DOI:10.1097/AOG.0000000000001267.
[31]
Shepherd ES,Goldsmith S,Doyle LW,et al.Magnesium sulphate for women at risk of preterm birth for neuroprotection of the fetus[J].Cochrane Database Syst Rev,2024,5(5):CD004661.DOI:10.1002/14651858.CD004661.pub4.
[32]
Rahman S,Ullah M,Ali A,et al.Fetal outcomes in preterm cesarean sections[J].Cureus,2022,14(8):e27607.DOI:10.7759/cureus.27607.
[33]
Luca A,Vinturache A,Ilea C,et al.Birth trauma in preterm spontaneous vaginal and cesarean section deliveries:a 10-years retrospective study[J].PLoS One,2022,17(10):e0275726.DOI:10.1371/journal.pone.0275726.
[34]
Gamaleldin I,Harding D,Siassakos D,et al.Significant intraventricular hemorrhage is more likely in very preterm infants born by vaginal delivery:a multi-centre retrospective cohort study[J].J Matern Fetal Neonatal Med,2019,32(3):477-482.DOI:10.1080/14767058.2017.1383980.
[35]
Yeo KT,Thomas R,Chow SS,et al.Improving incidence trends of severe intraventricular haemorrhages in preterm infants<32 weeks gestation:a cohort study[J].Arch Dis Child Fetal Neonatal Ed,2020,105(2):145-150.DOI:10.1136/archdischild-2018-316664.
[36]
Unger V,Gasparicsá,Nagy Z,et al.Cesarean delivery is associated with lower neonatal mortality among breech pregnancies:a systematic review and Meta-analysis of preterm deliveries≤32 weeks of gestation[J].Am J Obstet Gynecol,2024,231(6):589-598.e21.DOI:10.1016/j.ajog.2024.06.015.
[37]
American College of Obstetricians and Gynecologists,Society for Maternal-Fetal Medicine.Obstetric care consensus No.6:periviable birth[J].Obstet Gynecol,2017,130(4):e187-e199.DOI:10.1097/AOG.0000000000002352.
[38]
Tsao PC.Pathogenesis and prevention of intraventricular hemorrhage in preterm infants[J].J Korean Neurosurg Soc,2023,66(3):228-238.DOI:10.3340/jkns.2022.0288.
[39]
Mohamed MA,Aly H.Transport of premature infants is associated with increased risk for intraventricular haemorrhage[J].Arch Dis Child Fetal Neonatal Ed,2010,95(6):F403-F407.DOI:10.1136/adc.2010.183236.
[40]
Shipley L,Gyorkos T,Dorling J,et al.Risk of severe intraventricular hemorrhage in the first week of life in preterm infants transported before 72 hours of age[J].Pediatr Crit Care Med,2019,20(7):638-644.DOI:10.1097/PCC.0000000000001937.
[41]
Amer R,Moddemann D,Seshia M,et al.Neurodevelopmental outcomes of infants born at<29 weeks of gestation admitted to canadian neonatal intensive care units based on location of birth[J].J Pediatr,2018,196(1):31-37.e1.DOI:10.1016/j.jpeds.2017.11.038.
[42]
Blaxter L,Yeo M,Mc Nally D,et al.Neonatal head and torso vibration exposure during i nter-hospital transfer[J].Proc Inst Mech Eng H,2017,231(2):99-113.DOI:10.1177/0954411916680235.
[43]
Chen X,Li X,Chang Y,et al.Effect and safety of timing of cord clamping on neonatal hematocrit values and clinical outcomes in term infants:a randomized controlled trial[J].J Perinatol,2018,38(3):251-257.DOI:10.1038/s41372-017-0001-y.
[44]
Rabe H,Gyte GM,Díaz-Rossello JL,et al.Effect of timing of umbilical cord clamping and other strategies to influence placental transfusion at preterm birth on maternal and infant outcomes[J].Cochrane Database Syst Rev,2019,9(9):CD003248.DOI:10.1002/14651858.
[45]
Rabe H,Jewison A,Fernandez Alvarez R,et al.Milking compared with delayed cord clamping to increase placental transfusion in preterm neonates:a randomized controlled trial[J].Obstet Gynecol,2011,117(2 Pt 1):205-211.DOI:10.1097/AOG.0b013e3181fe46ff.
[46]
McDonald SD.Deferred cord clamping and cord milking:certainty and quality of the evidence in Meta-analyses,and systematic reviews of randomized control trials,guidelines,and implementation studies[J].Semin Perinatol,2023,47(5):151790.DOI:10.1016/j.semperi.2023.151790.
[47]
Delayed umbilical cord clamping after birth:ACOG committee opinion summary,number 814[J].Obstet Gynecol,2020,136(6):1238-1239.DOI:10.1097/AOG.0000000000004168.
[48]
Seidler AL,Aberoumand M,Hunter KE,et al.Deferred cord clamping,cord milking,and immediate cord clamping at preterm birth:a systematic review and individual participant data Meta-analysis[J].Lancet,2023,402(10418):2209-2222.DOI:10.1016/S0140-6736(23)02468-6.
[49]
Seidler AL,Libesman S,Hunter KE,et al.Short,medium,and long deferral of umbilical cord clamping compared with umbilical cord milking and immediate clamping at preterm birth:a systematic review and network Meta-analysis with individual participant data[J].Lancet,2023,402(10418):2223-2234.DOI:10.1016/S0140-6736(23)02469-8.
[50]
Katheria AC,Szychowski JM,Essers J,et al.Early cardiac and cerebral hemodynamics with umbilical cord milking compared with delayed cord clamping in infants born preterm[J].J Pediatr,2020,223:51-56.e1.DOI:10.1016/j.jpeds.2020.04.010.
[51]
Toledo JD,Rodilla S,Pérez-Iranzo A,et al.Umbilical cord milking reduces the risk of intraventricular hemorrhage in preterm infants born before 32 weeks of gestation[J].J Perinatol,2019,39(4):547-553.DOI:10.1038/s41372-019-0329-6.
[52]
Jasani B,Torgalkar R,Ye XY,et al.Association of umbilical cord management strategies with outcomes of preterm infants:a systematic review and network Metaanalysis[J].JAMA Pediatr,2021,175(4):e210102.DOI:10.1001/jamapediatrics.2021.0102.
[53]
Katheria A,Reister F,Essers J,et al.Association of umbilical cord milking vs delayed umbilical cord clamping with death or severe intraventricular hemorrhage among preterm infants[J].JAMA,2019,322(19):1877-1886.DOI:10.1001/jama.2019.16004.
[54]
Balasubramanian H,Ananthan A,Jain V,et al.Umbilical cord milking in preterm infants:a systematic review and Meta-analysis[J].Arch Dis Child Fetal Neonatal Ed,2020,105(6):572-580.DOI:10.1136/archdischild-2019-318627.
[55]
Razak A,Patel W,Durrani N,et al.Interventions to reduce severe brain injury risk in preterm neonates:a systematic review and Meta-analysis[J].JAMA Netw Open,2023,6(4):e237473.DOI:10.1001/jamanetworkopen.2023.7473.
[56]
Dunne EA,O' Donnell C,Nakstad B,et al.Thermoregulation for very preterm infants in the delivery room:a narrative review[J].Pediatr Res,2024,95(6):1448-1454.DOI:10.1038/s41390-023-02902-w.
[57]
Ramaswamy VV,Dawson JA,de Almeida MF,et al.Maintaining normothermia immediately after birth in preterm infants<34 weeks'gestation:a systematic review and Metaanalysis[J].Resuscitation,2023,191:109934.DOI:10.1016/j.resuscitation.2023.109934.
[58]
Altaany D,Natarajan G,Gupta D,et al.Severe intraventricular hemorrhage in extremely premature infants:are high carbon dioxide pressure or fluctuations the culprit?[J].Am J Perinatol,2015,32(9):839-844.DOI:10.1055/s-0034-1543950.
[59]
Aly S,El-Dib M,Lu Z,et al.Factors affecting cerebrovascular reactivity to CO2 in premature infants[J].J Perinat Med,2019,47(9):979-985.DOI:10.1515/jpm-2019-0031.
[60]
龚凌月,陈超,唐军,等.容量目标通气模式在新生儿呼吸支持中的应用指南[J].中国循证医学杂志,2022,22(2):125-133.DOI:10.7507/1672-2531.202110060.Gong LY,Chen C,Tang J,et al.Guidelines for the application of volume targeted ventilation in neonatal respiratory support[J].Chin J Evid-based Med,2022,22(2):125-133.DOI:10.7507/1672-2531.202110060.
[61]
Klingenberg C,Wheeler KI,McCallion N,et al.Volumetargeted versus pressure-limited ventilation in neonates[J].Cochrane Database Syst Rev,2017,10(10):CD003666.DOI:10.1002/14651858.
[62]
D'Amato G,Faienza MF,Palladino V,et al.Red blood cell transfusions and potentially related morbidities in neonates under 32 weeks'gestation[J].Blood Transfus,2021,19(2):113-119.DOI:10.2450/2020.0092-20.
[63]
Christensen RD,Baer VL,Lambert DK,et al.Association,among very-low-birthweight neonates,between red blood cell transfusions in the week after birth and severe intraventricular hemorrhage[J].Transfusion,2014,54(1):104-108.DOI:10.1111/trf.12234.
[64]
Iskander IF,Salama KM,Gamaleldin RM,et al.Neonatal RBC transfusions:do benefits outweigh risks? [J].Transfus Apher Sci,2018,57(3):431-436.DOI:10.1016/j.transci.2018.05.007.
[65]
Keir A,Pal S,Trivella M,et al.Adverse effects of red blood cell transfusions in neonates:a systematic review and Metaanalysis[J].Transfusion,2016,56(11):2773-2780.DOI:10.1111/trf.13785.
[66]
Mitra S,Florez ID,Tamayo ME,et al.Association of placebo,indomethacin,ibuprofen,and acetaminophen with closure of hemodynamically significant patent ductus arteriosus in preterm infants:a systematic review and Metaanalysis[J].JAMA,2018,319(12):1221-1238.DOI:10.1001/jama.2018.1896.
[67]
Van Overmeire B,Allegaert K,Casaer A,et al.Prophylactic ibuprofen in premature infants:a multicentre,randomised,double-blind,placebo-controlled trial[J].Lancet,2004,364(9449):1945-1949.DOI:10.1016/S0140-6736(04)17477-1.
[68]
Ment LR,Oh W,Ehrenkranz RA,et al.Low-dose indomethacin and prevention of intraventricular hemorrhage:a multicenter randomized trial[J].Pediatrics,1994,93(4):543-550.
[69]
Kalani M,Shariat M,Khalesi N,et al.A comparison of early ibuprofen and indomethacin administration to prevent intraventricular hemorrhage among preterm infants[J].Acta Med Iran,2016,54(12):788-792.
[70]
Mitra S,Boode WPD,Weisz DE,et al.Interventions for patent ductus arteriosus(PDA)in preterm infants:an overview of cochrane systematic reviews[J].Cohrane Database Syst Rev,2020,4(4):CD013588.DOI:10.1002/14651858.cd013588.
[71]
Pan I,Shah PA,Singh J,et al.Comparison of neonatal outcomes with and without prophylaxis with indomethacin in premature neonates[J].J Pediatr Pharmacol Ther,2021,26(5):478-483.DOI:10.5863/1551-6776-26.5.478.
[72]
Smit E,Odd D,Whitelaw A.Postnatal phenobarbital for the prevention of intraventricular haemorrhage in preterm infants[J].Cochrane Database Syst Rev,2013,2013 (8):CD001691.DOI:10.1002/14651858.CD001691.pub3.
[73]
Romantsik O,Smit E,Odd DE,et al.Postnatal phenobarbital for the prevention of intraventricular haemorrhage in preterm infants[J].Cochrane Database Syst Rev,2023,3(3):CD001691.DOI:10.1002/14651858.CD001691.pub4.
[74]
Song J,Sun H,Xu F,et al.Recombinant human erythropoietin improves neurological outcomes in very preterm infants[J].Ann Neurol,2016,80(1):24-34.DOI:10.1002/ana.24677.
[75]
Juul SE,Comstock BA,Wadhawan R,et al.A randomized trial of erythropoietin for neuroprotection in preterm infants[J].N Engl J Med,2020,382(3):233-243.DOI:10.1056/NEJMoa1907423.
[76]
Ohlsson A,Aher SM.Early erythropoiesis-stimulating agents in preterm or low birth weight infants[J].Cochrane Database Syst Rev,2017,11(11):CD004863.DOI:10.1002/14651858.CD004863.pub5.
[77]
Doucette SM,Kelly EN,Church PT,et al.Association of inotrope use with neurodevelopmental outcomes in infants<29 weeks gestation:a retrospective cohort study[J].J Matern Fetal Neonatal Med,2022,35(25):6044-6052.DOI:10.1080/14767058.2021.1904872.
[78]
St Peter D,Gandy C,Hoffman SB.Hypotension and adverse outcomes in prematurity:comparing definitions [J].Neonatology,2017,111 (3):228-233.DOI:10.1159/000452616.
[79]
Zaveri PG,Walker AM,Upadhyay K,et al.Use of vasopressors in extremely preterm infants in first week of life[J].Am J Perinatol,2023,40(5):513-518.DOI:10.1055/s-0041-1729558.
[80]
Batton B,Li L,Newman NS,et al.Use of antihypotensive therapies in extremely preterm infants[J].Pediatrics,2013,131(6):e1865-e1873.DOI:10.1542/peds.2012-2779.
[81]
Kuperman AA,Brenner B,Kenet G.Intraventricular hemorrhage in preterm infants and coagulation--ambivalent perspectives? [J].Thromb Res,2013,131(Suppl 1):S35-S38.DOI:10.1016/S0049-3848(13)70018-5.
[82]
Piotrowski A,Dabrowska-Wojciak I,Mikinka M,et al.Coagulation abnormalities and severe intraventricular hemorrhage in extremely low birth weight infants[J].J Matern Fetal Neonatal Med,2010,23(7):601-606.DOI:10.1080/14767050903229614.
[83]
Benson JW,Drayton MR,Hayward C,et al.Multicentre trial of ethamsylate for prevention of periventricular haemorrhage in very low birthweight infants[J].Lancet,1986,2(8519):1297-1300.DOI:10.1016/s0140-6736(86)91432-7.
[84]
Hunt R,Hey E.Ethamsylate for the prevention of morbidity and mortality in preterm or very low birth weight infants[J].Cochrane Database Syst Rev,2010,(1):CD004343.DOI:10.1002/14651858.
[85]
Kochan M,Leonardi B,Firestine A,et al.Elevated midline head positioning of extremely low birth weight infants:effects on cardiopulmonary function and the incidence of periventricular-intraventricular hemorrhage[J].J Perinatol,2019,39(1):54-62.DOI:10.1038/s41372-018-0261-1.
[1]
Ohuma EO,Moller AB,Bradley E,et al.National,regional,and global estimates of preterm birth in 2020,with trends from 2010:a systematic analysis[J].Lancet,2023,402(10409):1261-1271.DOI:10.1016/S0140-6736(23)00878-4.
[2]
Pierrat V,Marchand-Martin L,Marret S,et al.Neurodevelopmental outcomes at age 5 among children born preterm:EPIPAGE-2 cohort study[J].BMJ,2021,373:n741.DOI:10.1136/bmj.n741.
[3]
Lai GY,Shlobin N,Garcia RM,et al.Global incidence proportion of intraventricular haemorrhage of prematurity:a Meta-analysis of studies published 2010-2020[J].Arch Dis Child Fetal Neonatal Ed,2022,107(5):513-519.DOI:10.1136/archdischild-2021-322634.
[4]
Zhu Z,Yuan L,Wang J,et al.Mortality and morbidity of infants born extremely preterm at tertiary medical centers in China from 2010 to 2019[J].JAMA Netw Open,2021,4(5):e219382.DOI:10.1001/jamanetworkopen.2021.9382.
[5]
Zhou M,Wang S,Zhang T,et al.Neurodevelopmental outcomes in preterm or low birth weight infants with germinal matrix-intraventricular hemorrhage:a Metaanalysis[J].Pediatr Res,2024,95(3):625-633.DOI:10.1038/s41390-023-02877-8.
[6]
Shehzad I,Raju M,Jackson I,et al.Evaluation of autism spectrum disorder risk in infants with intraventricular hemorrhage[J].Cureus,2023,15(9):e45541.DOI:10.7759/cureus.45541.
[7]
刘敬,俞惠民,毛健,等.早产儿脑损伤诊断与防治专家共识[J].中国当代儿科杂志,2012,14(12):883-884.Liu J,Yu HM,Mao J,et al.Expert consensus on the diagnosis,prevention and treatment of brain injury in premature infants[J].Chin J Contemp Pediatr,2012,14(12):883-884.
[8]
Guyatt GH,Oxman AD,Vist GE,等.GRADE:证据质量和推荐强度分级的共识[J].中国循证医学杂志,2009,9(1):8-11.DOI:10.7507/1672-2531.20090005.Guyatt GH,Oxman AD,Vist GE,et al.GRADE:an emerging consensus on rating quality of evidence and strength of recommendations[J].Chin J Evid-based Med,2009,9(1):8-11.DOI:10.7507/1672-2531.20090005.
[9]
Gilard V,Tebani A,Bekri S,et al.Intraventricular hemorrhage in very preterm infants:a comprehensive review[J].J Clin Med,2020,9(8):2447.DOI:10.3390/jcm9082447.
[10]
Barrington K,El-Khuffash A,Dempsey E.Intervention and outcome for neonatal hypotension[J].Clin Perinatol,2020,47(3):563-574.DOI:10.1016/j.clp.2020.05.011.
[11]
Garvey AA,Walsh BH,Inder TE.Pathogenesis and prevention of intraventricular hemorrhage [J].Semin Perinatol,2022,46(5):151592.DOI:10.1016/j.semperi.2022.151592.
[12]
Çizmeci MN,Akın MA,Özek E.Turkish neonatal society guideline on the diagnosis and management of germinal matrix hemorrhage-intraventricular hemorrhage and related complications[J].Turk Arch Pediatr,2021,56(5):499-512.DOI:10.5152/Turk ArchPediatr.2021.21142.
[13]
Rajaram A,Milej D,Suwalski M,et al.Assessing cerebral blood flow,oxygenation and cytochrome c oxidase stability in preterm infants during the first 3 days after birth[J].Sci Rep,2022,12(1):181.DOI:10.1038/s41598-021-03830-7.
[14]
Sheng L,Zhong G,Xing R,et al.Quality improvement in the golden hour for premature infants:a scoping review[J].BMC Pediatr,2024,24(1):88.DOI:10.1186/s12887-024-04558-9.
[15]
Parodi A,Govaert P,Horsch S,et al.Cranial ultrasound findings in preterm germinal matrix haemorrhage,sequelae and outcome[J].Pediatr Res,2020,87(Suppl 1):13-24.DOI:10.1038/s41390-020-0780-2.
[16]
Papile LA,Burstein J,Burstein R,et al.Incidence and evolution of subependymal and intraventricular hemorrhage:a study of infants with birth weights less than 1,500 gm[J].J Pediatr,1978,92(4):529-534.DOI:10.1016/s0022-3476(78)80282-0.
[17]
Volpe JJ.Neurology of the newborn [M].5th ed.Philadelphia:Saunders,2008.
[18]
Mc Lean G,Malhotra A,Lombardo P,et al.Cranial ultrasound screening protocols for very preterm infants[J].Ultrasound Med Biol,2021,47(7):1645-1656.DOI:10.1016/j.ultrasmedbio.2021.03.006.
[19]
Philip AG,Allan WC,Tito AM,et al.Intraventricular hemorrhage in preterm infants:declining incidence in the 1980s[J].Pediatrics,1989,84(5):797-801.
[20]
Mohammad K,Scott JN,Leijser LM,et al.Consensus approach for standardizing the screening and classification of preterm brain injury diagnosed with cranial ultrasound:a Canadian perspective[J].Front Pediatr,2021,9:618236.DOI:10.3389/fped.2021.618236.
[21]
Hand IL,Shellhaas RA,Milla SS,et al.Routine neuroimaging of the preterm brain[J].Pediatrics,2020,146(5):e2020029082.DOI:10.1542/peds.2020-029082.
[22]
Garite TJ,Rumney PJ,Briggs GG,et al.A randomized,placebo-controlled trial of betamethasone for the prevention of respiratory distress syndrome at 24 to 28 weeks'gestation[J].Am J Obstet Gynecol,1992,166(2):646-651.DOI:10.1016/0002-9378(92)91691-3.
[23]
McGoldrick E,Stewart F,Parker R,et al.Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth[J].Cochrane Database Syst Rev,2020,12(12):CD004454.DOI:10.1002/14651858.CD004454.pub4.
[24]
Tsakiridis I,Mamopoulos A,Athanasiadis A,et al.Antenatal corticosteroids and magnesium sulfate for improved preterm neonatal outcomes:a review of guidelines[J].Obstet Gynecol Surv,2020,75(5):298-307.DOI:10.1097/OGX.0000000000000778.
[25]
Helwich E,Rutkowska M,Bokiniec R,et al.Intraventricular hemorrhage in premature infants with respiratory distress syndrome treated with surfactant:incidence and risk factors in the prospective cohort study[J].Dev Period Med,2017,21(4):328-335.DOI:10.34763/devperiodmed.20172104.328335.
[26]
Williams MJ,Ramson JA,Brownfoot FC.Different corticosteroids and regimens for accelerating fetal lung maturation for babies at risk of preterm birth[J].Cochrane Database Syst Rev,2022,8(8):CD006764.DOI:10.1002/14651858.CD006764.pub4.
[27]
Huusom LD,Wolf HT.Antenatal magnesium sulfate treatment for women at risk of preterm birth is safe and might decrease the risk of cerebral palsy[J].BMJ Evid Based Med,2018,23(5):195-196.DOI:10.1136/bmjebm-2018-110897.
[28]
Bansal V,Desai A.Efficacy of antenatal magnesium sulfate for neuroprotection in extreme prematurity:a comparative observational study[J].J Obstet Gynaecol India,2022,72(Suppl 1):36-47.DOI:10.1007/s13224-021-01531-9.
[29]
Zeng X,Xue Y,Tian Q,et al.Effects and safety of magnesium sulfate on neuroprotection:a Meta-analysis based on PRISMA guidelines[J].Medicine (Baltimore),2016,95(1):e2451.DOI:10.1097/MD.0000000000002451.
[86]
Romantsik O,Calevo MG,Bruschettini M.Head midline position for preventing the occurrence or extension of germinal matrix-intraventricular hemorrhage in preterm infants[J].Cochrane Database Syst Rev,2017,7(7):CD012362.DOI:10.1002/14651858.
[87]
Romantsik O,Calevo MG,Bruschettini M.Head midline position for preventing the occurrence or extension of germinal matrix-intraventricular haemorrhage in preterm infants[J].Cochrane Database Syst Rev,2020,7(7):CD012362.DOI:10.1002/14651858.
[88]
de Bijl-Marcus K,Brouwer AJ,De Vries LS,et al.Neonatal care bundles are associated with a reduction in the incidence of intraventricular haemorrhage in preterm infants:a multicentre cohort study[J].Arch Dis Child Fetal Neonatal Ed,2020,105(4):419-424.DOI:10.1136/archdischild-2018-316692.
[1] 国家感染性疾病医疗质量控制中心. 肺结核诊治质量改进专家共识[J/OL]. 中华实验和临床感染病杂志(电子版), 2025, 19(01): 9-14.
[2] 国家感染性疾病医疗质量控制中心. 阻断乙型肝炎病毒母婴传播质量改进专家共识[J/OL]. 中华实验和临床感染病杂志(电子版), 2025, 19(01): 23-29.
[3] 中国医师协会外科医师分会肥胖代谢病综合管理与护理专家工作组, 中国医师协会外科医师分会肥胖和代谢病外科专家工作组, 中国肥胖代谢外科研究协作组. 肥胖代谢外科医学科普中国专家共识(2024 版)[J/OL]. 中华普通外科学文献(电子版), 2025, 19(01): 1-8.
[4] 《中华疝和腹壁外科杂志(电子版)》编辑委员会, 全国卫生产业企业管理协会疝和腹壁外科产业及临床研究分会, 中国医师协会外科医师分会疝和腹壁外科专家工作组, 中华医学会外科学分会疝与腹壁外科学组, 中华消化外科菁英荟疝与腹壁外科学组, 中华志愿者协会中西医结合专家工作委员会疝和腹壁外科专业组, 《中华疝和腹壁外科杂志(电子版)》编辑委员会. 成人腹股沟疝日间手术管理模式下加速康复策略专家共识[J/OL]. 中华疝和腹壁外科杂志(电子版), 2025, 19(02): 125-131.
[5] 中国研究型医院学会微创外科专业委员会, 中国研究型医院学会智能医学专业委员会. 胰管(修复)外科专家共识[J/OL]. 中华腔镜外科杂志(电子版), 2025, 18(02): 65-72.
[6] 中国研究型医院学会微创外科学专业委员会, 中国研究型医院学会智能医学专业委员会. 机器人肝门部胆管癌根治术专家共识[J/OL]. 中华腔镜外科杂志(电子版), 2025, 18(02): 73-77.
[7] 中国研究型医院学会微创外科学专业委员会, 中国研究型医院学会智能医学专业委员会. 机器人胆囊癌根治术专家共识[J/OL]. 中华腔镜外科杂志(电子版), 2025, 18(02): 78-82.
[8] 中国研究型医院学会微创外科学专业委员会. 腹腔镜肝脏尾状叶切除术中国专家共识(2024 版)[J/OL]. 中华腔镜外科杂志(电子版), 2025, 18(01): 1-7.
[9] 中国研究型医院学会微创外科学专业委员会. 腹腔镜脾部分切除术中国专家共识(2024 版)[J/OL]. 中华腔镜外科杂志(电子版), 2025, 18(01): 8-14.
[10] 张琳琳, 周建新. 重症神经:2024年度进展与展望[J/OL]. 中华重症医学电子杂志, 2025, 11(01): 11-16.
[11] 曾坚锋, 李钢, 刘成业, 王辉. 神经内镜微创手术治疗高血压脑出血的临床效果分析[J/OL]. 中华脑科疾病与康复杂志(电子版), 2025, 15(01): 26-30.
[12] 李华泉, 陶国荣, 温剑峰, 许海泽, 邓磊, 龚存林, 秦荣. 硬性脑内镜辅助手术治疗脑室出血血肿铸型的疗效分析[J/OL]. 中华脑科疾病与康复杂志(电子版), 2024, 14(06): 353-358.
[13] 中国医师协会心血管内科医师分会结构性心脏病学组;苏州工业园区东方华夏心血管健康研究院. 中国经导管左心耳封堵术临床路径专家共识(2025版)[J/OL]. 中华心脏与心律电子杂志, 2025, 13(01): 1-28.
[14] 中华医学会消化内镜学分会. 抗栓药物治疗患者超级微创手术围手术期管理专家共识(2025,北京)[J/OL]. 中华胃肠内镜电子杂志, 2025, 12(01): 7-14.
[15] 王辉, 胡玉姣, 李鹏飞. 老年高血压脑出血患者脑血肿扩大影响因素的预测价值[J/OL]. 中华脑血管病杂志(电子版), 2025, 19(01): 48-53.
阅读次数
全文


摘要