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目的 研究窒息新生儿的脑血流动力学改变及头颅超声和CT声像图特征 ,综合评价其对新生儿窒息后脑损伤早期的应用价值。方法 应用彩色多普勒超声、二维超声监测了 2 2例窒息新生儿和 10例正常新生儿出生后 1、2、3、4d的脑血流参数变化、侧脑室及脑实质回声的变化 ,并于 72h内行CT扫描。结果 ①窒息新生儿生后第 1d大脑动脉血流频谱和血流动力学参数有明显变化 ,阻力指数 (RI)显示不同变化形式 ;②窒息新生儿生后第 1、2d侧脑室未显示率前角分别为 6 3%、30 % ,体部分别为 5 4%、2 5 % ,伴随脑实质回声广泛增强 ;③蛛网膜下腔少量出血 15例 ,侧脑室出血 5例 ,脑实质出血 1例。结论 RI是反映脑血管调节功能的重要参数 ,RI升高为 1.0或 <0 .5可做为判断预后的指标之一。头颅超声是观察弥漫性脑水肿时侧脑室变化的最佳方法 ,RI变化与脑水肿改变平行 ,两者结合是判断病情及预后的重要指标。CT对颅内出血的诊断优于头颅超声。
Objective To study the changes of cerebral hemodynamics and the characteristics of cranial ultrasound and CT ultrasonography in neonates with asphyxia and to evaluate their application in the early stage of brain injury after neonatal asphyxia. Methods The changes of cerebral blood flow parameters, the changes of the echoes of the lateral ventricle and the brain parenchyma were detected by color Doppler ultrasound and two-dimensional ultrasonography in the neonates with asphyxia and normal neonates at 1, 2, And within 72h CT scan. Results ① Asphyxia newborns had significant changes in the frequency and hemodynamic parameters of cerebral arteries on day 1, and the resistance index (RI) showed different changes. ② Asphyxia Angle were 63%, 30%, body parts were 54%, 25%, accompanied by extensive enhancement of brain parenchyma; ③ 15 cases of subarachnoid hemorrhage, 5 cases of lateral ventricular hemorrhage, 1 case of cerebral parenchymal hemorrhage . Conclusions RI is an important parameter that reflects the regulation of cerebrovascular function. RI increased to 1.0 or <0.5 can be used as one of the prognostic indicators. Head ultrasound is the best way to observe the change of lateral ventricle in diffuse cerebral edema. The change of RI is parallel to the change of cerebral edema. The combination of the two is an important index to judge the condition and prognosis. CT is superior to cranial ultrasound in the diagnosis of intracranial hemorrhage.