多普勒超声评价新生儿脑室周围-脑室内出血  

Doppler ultrasonographic assessment of neonatal periventricular-intraventricular hemorrhage

作　　者：吴传妹[1] 李智贤[1] 刘军杰[1] 钟丹妮[2] 田桂湘[1] 丁雪明[1] 韦柳[1] 王斯达[1] 

机构地区：[1]广西医科大学第一附属医院超声诊断科,广西南宁530021 [2]广西医科大学第一附属医院新生儿科,广西南宁530021

出　　处：《中国医学影像技术》2013年第3期339-343,共5页Chinese Journal of Medical Imaging Technology

基　　金：国家"十一五"科技支撑计划课题项目(2007BAI07A17-11);广西卫生厅自筹项目(Z2012055)

摘　　要：目的探讨不同程度脑室周围-脑室内出血(PIVH)新生儿大脑中动脉(MCA)的血流动力学变化。方法对321名出生1周内新生儿行颅脑超声检查,测定双侧MCA的收缩期峰值流速(Vs)、舒张期末流速(Vd)及阻力指数(RI)。根据结果将新生儿分为对照组(83名)、PIVHⅠ级组(90例)、Ⅱ级组(106例)、Ⅲ级组(21例)和Ⅳ级组(21例),分析各组间MCA的血流动力学变化特点。结果各组新生儿出生后1周内Vs均随着日龄增加而增高。PIVHⅠ级组新生儿3天内Vs明显低于对照组和PIVHⅡ级组(P均<0.05),高于PIVHⅢ、Ⅳ级组(P均<0.05);PIVHⅡ级组新生儿7天内Vs及3天内Vd明显高于其他各组(P均<0.05);PIVHⅢ、Ⅳ级组新生儿7天内Vs及3天内Vd显著低于对照组和PIVHⅠ、Ⅱ级组(P均<0.05),PIVHⅢ、Ⅳ级组间比较血流参数差异无统计学意义(P均>0.05)。各组间RI差异无统计学意义(P均>0.05)。结论多普勒超声可动态监测PIVH患儿MCA血流动力学变化。Objective： To assess the hemodynamics of middle cerebral artery （MCA） in different grades of neonatal periventricular-intraventricular hemorrhage （PIVH） with Doppler ultrasonography. Methods： Totally 321 newborns who underwent routine cerebral ultrasonography were divided into control group （n=83）, grade Ⅰ PIVH group （n=90）, grade Ⅱ PIVH group （n=106）, grade Ⅲ PIVH group （n=21） and grade Ⅳ PIVH group （n=21）. The hemodynamics of MCA were detected, including bilateral velocity systolic （Vs）, velocity diastole （Vd） and resistance index （RI）, and hemodyniamic changes of MCA in each group were compared and analyzed. Results： Within 1 week after delivery, there was a linear increase of Vs with the increasing of age. Vs of 3 days in grade Ⅰ PIVH group was lower than that in control group and grade Ⅱ PIVH group （both P〈0.05）, but higher than that in grade Ⅲ and Ⅳ PIVH groups （both P〈0.05）. Vs of 7 days and Vd of 3 days in gradeⅡ PIVH group were significantly higher than those in other PIVH groups （all P〈0.05）. Vs of 7 days and Vd of 3 days in grade Ⅲ, Ⅳ PIVH groups were lower than those in gradeⅠ, Ⅱ PIVH groups and control group （all P〈0.05）. The difference of blood flow velocity of MCA had no significant difference between grade Ⅲ and Ⅳ PIVH group （all P〉0.05）. There was no significant difference of RI among all groups （all P〉0.05）. Conclusion： Doppler ultrasonography can monitor the progression of neonatal PIVH.

关 键 词：婴儿 新生儿 脑室周围-脑室内出血 超声检查 大脑中动脉 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.53[医药卫生—诊断学]