新生儿缺氧缺血性脑病的CT诊断  

作　　者：宾精文[1] 宁尚峰[1] 杨鸿[1] 

机构地区：[1]广西壮族自治区第二人民医院影像科,541002

出　　处：《当代医学》2010年第25期5-7,共3页Contemporary Medicine

摘　　要：目的回顾性分析我院94例经临床和CT确诊的围产期缺氧缺血性脑病(HIE)病例,结合有关文献进行分析讨论,旨在提高对本病的诊断水平。方法 94例新生儿缺氧缺血性脑病中,男59例,女35例。胎龄38周～42周,检查时间从出生后3小时至12天。其中顺产30例,胎儿吸引器助产16例,产钳助产15例,剖腹产33例。所有病例都有不同程度的窒息史。结果 CT表现为两侧脑室周围脑白质和灰质呈弥漫性或两侧不对称性低密度影,CT值约8～18,边界模糊,大脑灰白质分界不清,脑室不同程度受压变窄甚至完全消失。其中伴有蛛网膜下腔出血23例;硬膜下出血15例;脑实质出血13例;脑室内出血6例;室管膜下出血2例;头皮血肿10例,颅骨骨折3例。结论 CT检查能直观地反映新生儿大脑缺氧缺血的程度和范围,并能根据CT表现及脑水肿大小范围进行分度,为临床诊断和治疗及预后评估提供客观依据。Objective This is a retrospective investigation of 90 cases of perinatal HIE diagnosed in junan hospital with literature review, made to improve the diagnosis of HIE.Methods In total 90 patients with HIE.including 58 males and 32 females,aged from 38 weeks to 42 weeks, underwent examination in 3 hours to 12 days after the delivery.There was natural laboy in 29 cases.vacuun labor in 15cases.foyceps delivery in 14 cases.abdominal delivery in 32 cases.All the neonatal infants had a history of asphyxia on different levels.Results CT scan showed diffuse or asymmetrical hypodense shadows with poorly-defined border,where the CT value measured between 8-18 HU,accompanying with the displacement or even absence of lateral ventricle.subarachnoid hemorrhage were found in 23 cases,subdural hemorrhage in 15 cases.parenchyma hemorrhage in 13 cases,intraventricular hemorrhage in 6 cases.and.Additionally,scalp turgidity was seen in 10 cases,and skull fracture in 3 cases as well.Conclusion The CT scan shows the anoxic-asphyxial lesions in the brain resulting from asphyxiation in neonatal,and the severity is rated with CT manifestation and brain edema,which provide objective guidance of the prognosis and the clinical management of HIE.

关 键 词：新生儿 缺氧缺血脑病 体层摄影术 X线计算机 

分 类 号：R473.72[医药卫生—护理学]