论文部分内容阅读
目的探讨二维及多普勒超声技术在新生儿缺血缺氧性脑病(HIE)诊疗中的临床应用价值。方法 34例临床诊断为HIE患儿(试验组),其中男性20例,女性14例;胎龄39～41周,平均胎龄39.2周(标准差1.3周);出生平均体质量3150g(标准差54 g)。应用SonoScape S8超声诊断仪测定HIE足月新生儿大脑中动脉各项血流参数[收缩期血流速度(Vs)、舒张期血流速度(Vd);平均血流速度(Vm)、阻力指数(RI)],分别于出生后24h及72h内检查,并与40例正常足月儿(对照组)的大脑中动脉血流参数进行对照分析。结果试验组患儿24h内20例表现为脑室周围白质回声异常增强,72h内所有患儿均出现双侧脑半球回声弥漫性增强。试验组患儿24h大脑中动脉Vs升高,Vd降低,72h Vs与Vd均升高,与对照组比较差异有统计学意义(P<0.05);大脑中动脉RI于24h内较对照组升高(P<0.05),而72h内降低(P<0.05)。结论超声影像能够动态观察HIE患儿颅内二维形态、回声改变及脑血流灌注的动态情况,早期诊断脑水肿,为临床诊疗提供有价值的依据。
Objective To investigate the clinical value of two-dimensional and Doppler ultrasound in the diagnosis and treatment of neonatal hypoxic-ischemic encephalopathy (HIE). Methods 34 cases of HIE were randomly divided into experimental group (20 males and 14 females). The gestational age ranged from 39 to 41 weeks (mean standard deviation 1.3 weeks). The mean birth weight was 3150 g (standard deviation 54 g). The blood flow parameters (systolic blood flow velocity (Vs), diastolic blood flow velocity (Vd), mean blood flow velocity (Vm), resistance index ( RI)] were examined at 24h and 72h after birth, respectively, and compared with 40 normal term children (control group), middle cerebral artery blood flow parameters were analyzed. Results In the experimental group, 20 cases showed abnormal enhancement of periventricular white matter echogenicity in 24h and all children in the experimental group showed diffuse enhancement of bilateral cerebral hemisphere echo. In the experimental group, the Vs of middle cerebral artery increased 24 h, Vd decreased, and Vs and Vd increased at 72 h in the experimental group, which was significantly different from the control group (P <0.05) (P <0.05), but decreased within 72 hours (P <0.05). Conclusion Ultrasound images can dynamically observe the intracranial two-dimensional morphology, echo changes and cerebral perfusion in children with HIE and early diagnosis of cerebral edema, providing valuable evidence for clinical diagnosis and treatment.