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目的:探讨新生儿缺氧缺血性脑病(HIE)的脑血流动力学变化及血流频谱特点,并探讨其临床意义。方法:对52例HIE患儿进行经颅多普勒超声(TCD)检测,包括大脑中动脉(MCA),大脑前动脉(ACA),大脑后动脉(PCA)的血流速度,频谱形态,搏动指数(PI),阻力指数(RI),异常声频的检测,以健康新生儿15例为正常对照组。结果:①脑血流轻度组舒张末期流速(Vd)、收缩峰流速(Vs)局部降低,中、重度组Vd广泛降低,Vs局部降低,重度组尤为显著(P<0.05);②PI、RI轻度组与对照组差异无统计学意义,中度组局部增高,重度组双侧大脑动脉PI、RI普遍增高(P<0.05)。结论:运用脉冲多普勒超声检测脑血流动力学变化,可用于HIE的早期诊断,病情判断和预后评估,对指导治疗具有重要意义。
Objective: To investigate the changes of hemodynamics and the characteristics of blood flow spectrum in neonates with hypoxic-ischemic encephalopathy (HIE) and to explore its clinical significance. Methods: Transcranial Doppler echocardiography (TCD) was performed in 52 children with HIE, including the blood flow velocity, shape and pulse of middle cerebral artery (MCA), anterior cerebral artery (ACA) and posterior cerebral artery (PCA) Index (PI), resistance index (RI), abnormal audio detection, 15 healthy newborns as the normal control group. Results: (1) Vd in the cerebral blood flow mild group decreased locally and the peak systolic velocity (Vs) decreased in the moderate and severe group, but Vs decreased in the moderate and severe group (P <0.05); ② PI, RI There was no significant difference between the mild group and the control group, while the moderate group was locally increased. The PI and RI of the bilateral cerebral arteries in the severe group were generally higher (P <0.05). Conclusion: The detection of cerebral hemodynamic changes by pulsed Doppler echocardiography can be used for the early diagnosis of HIE, the judgment of the disease and the prognosis evaluation. It is of great significance for the guiding therapy.