摘要
目的探讨床旁颅脑超声检查对新生儿缺氧缺血性脑病(HIE)早期诊断的价值。方法选取我院收治的120例HIE患儿为观察组,同时期80例健康新生儿为对照组,于出生后72 h内对两组患儿行床旁颅脑超声检查,7天后对观察组患儿进行复查,对比声像图改变及大脑中动脉(MCA)中央支的脑血流变化情况。结果观察组120例HIE患儿根据临床症状分为轻度68例、中度32例、重度20例,出生后48 h内,观察组患儿MCA中央支的收缩期峰值流速(Vs)、舒张末期流速(Vd)均低于对照组,而阻力指数(RI)明显高于对照组,差异有统计学意义(P<0.05);72 h内轻度及中度HIE患儿MCA中央支的收缩期峰值流速(Vs)、舒张末期流速(Vd)仍低于对照组,阻力指数(RI)高于对照组,但降低及升高的幅度不大,差异无统计学意义(P>0.05);重度HIE组患儿Vs、Vd下降显著,RI异常升高,差异有统计学意义(P<0.05)。7天后对观察组患儿进行复查,轻度组患儿MCA中央支脑血流参数恢复至正常水平,中、重度组患儿中,8例出现不同程度脑白质损伤,3例出现脑室周围-脑室内出血(PIVH)。结论颅脑超声检查通过监测新生儿脑血流变化及声像图改变可对HIE做出早期诊断,可为临床尽早干预提供影像学诊断依据。
Objective To explore the value of bedside craniocerebral ultrasound in the early diagnosis of neonatal hypoxic ischemic encephalopathy(HIE).Methods 120 new borns with HIE treated by new pediatric were selected as the observation group,80 healthy newborns as the control group,and examining with the cerebral ultrasound by the bed within 72 h.We reviewed the HIE group 7 days later,contrasted ultrasonographic changes,and observed the hemodynamic changes of the central branches of middle cerebral artery.Results 120 neonates with diagnosis of HIE were divided into the mild(68),moderate(32),severe(20)according to clinical symptoms.Compared with the control group,tht HIE group Vs and Vd of the central branches of middle cerebral artery were lower and the RI was higher within 48h after birth,and the difference was tatistically significant(P<0.05);Within 72 h,the Vs and Vd of the central branches of middle cerebral artery with mild and moderate HIE were still lower and the RI was higher than those in the control group,but the decrease and increase were not significant(P>0.05).In the severe HIE group,Vs and Vd decreased significantly and RI increased abnormally,with statistically significant difference(P<0.05).Seven days later,children in the HIE group were re-examined.Blood flow parameters of the central branches of middle cerebral artery in the mild group returned to normal level;among the children in the moderate and severe groups,8 children had different degrees of periventricular leukomalacia,and 3 children had periventricular intraventricular hemorrhage(PIVH).Conclusion Craniocerebral ultrasound can make early diagnosis of HIE by monitoring the changes of cerebral blood flow and sonogram of newborn,and provide imaging diagnosis basis for early clinical intervention.
作者
魏郑虎
霍亚玲
王丹
郑彬
许晶
WEI Zhenghu;HUO Yaling;WANG Dan;ZHENG Bin;XU Jing(Department of Ultrasound, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hosipital, Zhengzhou Children’s Hosipital, Zhengzhou 450000, P.R.China;Department of Radiology, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hosipital, Zhengzhou Children’s Hosipital, Zhengzhou 450000, P.R.China)
出处
《医学影像学杂志》
2021年第8期1270-1273,共4页
Journal of Medical Imaging
基金
2018年度河南省医学科技攻关计划(联合共建项目)(编号:2018020612)。
关键词
新生儿
颅脑超声检查
缺氧缺血性脑病
早期诊断
Neonatal
Craniocerebral ultrasound
Hypoxic Ischemic Encephalopathy
Early diagnosis
