经颅彩色多普勒超声对新生儿缺氧缺血性脑病早期诊断与预后评估  

Early Diagnosis and Prognosis of Neonatal Hypoxic-ischemic Encephalopathy with Transcranial Color Doppler Ultrasound

作　　者：杨浩[1] 邹文英[2] 尹家保[1] 吕瑾玉[1] 钟静[1] 周素芬[1] 安鹏[1] 

机构地区：[1]湖北医药学院附属襄阳医院超声科,湖北襄阳441000 [2]湖北医药学院附属襄阳医院儿科,湖北襄阳441000

出　　处：《湖北医药学院学报》2013年第2期139-142,191,共5页Journal of Hubei University of Medicine

基　　金：湖北省襄阳市科技基金项目(2011-5)

摘　　要：目的:探讨二维和彩色多普勒超声对新生儿缺氧缺血性脑病(Neonatal hypoxic-ischemic encephalopathy,NHIE)的早期诊断和预后评估。方法:对50例经临床和CT证实的NHIE住院足月新生儿在出生后1～4 d连续进行彩色多普勒超声检查。观察患儿脑实质变化,测定脑血流参数。同期健康足月新生儿45例作为对照组。结果:NH-IE脑实质回声的变化表现为不同程度和范围的强回声,颅内结构显示欠清晰,脑沟变浅,侧脑室受压变窄。轻、中度NHIE值第一天大脑血流速度(CBFV)降低,阻力指数(RI)升高,重度NHIE值则出现相反改变,在随后3 d轻、中度NHIE值脑血流动力学参数有不同程度恢复,重度NHIE值则持续异常。结论:经颅彩色多普勒超声简便易行,能早期诊断NHIE并对预后作出判断。Objective To investigate the value of two-dimensional and color Doppler ultrasound in early diagnosis and prognosis of neonatal hypoxic-ischemic encephalopathy(NHIE).Methods Fifty neonates with NHIE confirmed by clinical and CT were given color Doppler ultrasound examination from one to four days after birth.The changes of brain parenchymal fraction in neonates were observed,and the parameters of cerebral blood flow were determined.Forty-five healthy full-term neonates were selected as control group at the same period.Results The changes of brain parenchymal fraction in neonates demonstrated different extent and scope of hyperecho,the intracranial structures could not be clearly showed,the cortical sulci became light,the lateral ventricle became narrow caused by pressure.The brain blood flow velocity(CBFV) in light and moderate NHIE groups were decreased and the resistance index(RI) were increased on the first day,but the changes were opposite in severe NHIE group.The parameters of blood flow were slowly recovered in light and moderate NHIE groups,which were still abnormal in severe NHIE group in the following three days.Conclusion Transcranial color Doppler ultrasound is a convenient method for early diagnosis and evaluating prognosis of NHIE.

关 键 词：经颅彩色多普勒超声 足月新生儿 缺氧缺血性脑病 早期诊断 预后评估 

分 类 号：R722.1[医药卫生—儿科]