TCD在小儿脓毒症相关性脑病评估中的应用研究  

Application of TCD in evaluation of sepsis-associated encephalopathy in children

作　　者：马伟科[1] MA Wei-ke(PICU Department,Shenzhen Children’s Hospital,Shenzhen 518038,China)

机构地区：[1]深圳市儿童医院重症医学科,518038

出　　处：《中国实用医药》2020年第6期4-6,共3页China Practical Medicine

基　　金：深圳市卫生和计划生育委员会重点学科提升项目(项目编号:201506055)。

摘　　要：目的探讨经颅多普勒(TCD)在小儿脓毒症相关性脑病(SAE)评估中的应用价值。方法35例脓毒症相关性脑病患儿作为观察组,同期诊断为脓毒症而无脓毒症相关性脑病的患儿20例作为对照组。比较两组患儿的脑血流异常情况;比较两组患儿住院第1、3天的大脑中动脉脑血流指标[大脑中动脉收缩期峰流速(Vs)、血管搏动指数(PI)、脑血流指数(CBFi)]差异。结果观察组脑血流异常率为77.1%,高于对照组的45.0%,差异具有统计学意义(P<0.05)。住院第1天,观察组患儿的Vs(182.47±22.36)cm/s、PI(1.25±0.13)均高于对照组的(160.30±40.45)cm/s、(0.82±0.12),CBFi(653.33±130.53)低于对照组的(783.65±80.46),差异均具有统计学意义(P<0.05)。住院第3天,观察组患儿的Vs(142.00±28.71)cm/s与对照组的(143.28±34.36)cm/s比较,差异无统计学意义(P>0.05);观察组患儿的PI(1.31±0.13)、CBFi(597.94±104.58)均高于对照组的(0.85±0.12)、(498.65±60.13),差异均具有统计学意义(P<0.05)。观察组患儿住院第3天的Vs低于住院第1天,差异具有统计学意义(P<0.05);住院第3天的PI及CBFi与住院第1天比较,差异均无统计学意义(P>0.05)。对照组患儿住院第3天的Vs及PI与住院第1天比较,差异均无统计学意义(P>0.05);住院第3天的CBFi低于住院第1天,差异具有统计学意义(P<0.05)。结论对脓毒症患儿行TCD检查能够早期发现脓毒症相关性脑病,并对评估脓毒症患儿的预后具有一定的指导意义。Objective To discuss the application value of transcranial Doppler(TCD)in evaluation of sepsis-associated encephalopathy(SAE)in children.Methods There were 35 children with sepsis-associated encephalopathy selected as observation group,and 20 children without sepsis-associated encephalopathy selected as control group.The abnormal situation of cerebral blood flow,and the difference of cerebral blood flow index of middle cerebral artery[peak systolic velocity(Vs),pulsatility index(PI),cerebral blood flow index(CBFi)of middle cerebral artery]on 1st and 3rd day of hospitalization were compared between the two groups.Results The abnormal rate of cerebral blood flow was 77.1%in the observation group,which was higher than 45.0%in the control group,and the difference was statistically significant(P<0.05).On 1st day of hospitalization,the Vs(182.47±22.36)cm/s and PI(1.25±0.13)in the observation group higher than(160.30±40.45)cm/s and(0.82±0.12)in the control group,and CBFi(653.33±130.53)was lower than(783.65±80.46)in the control group.Their difference was statistically significant(P<0.05).On 3rd day of hospitalization,the Vs was(142.00±28.71)cm/s in the observation group,which had no statistically significant difference compared with(143.28±34.36)cm/s in the control group(P>0.05).The PI(1.31±0.13)and CBFi(597.94±104.58)in the observation group was higher than(0.85±0.12)and(498.65±60.13)in the control group,and their difference was statistically significant(P<0.05).In the observation group,the VS on the 3rd day of hospitalization was lower than that on the 1st day of hospitalization,and the difference was statistically significant(P<0.05).There was no significant difference in PI and CBFi between the 3rd day and the 1st day of hospitalization(P>0.05).In the control group,there was no statistically significant difference in Vs and PI between the 3rd day and the 1st day of hospitalization(P>0.05),CBFi on the 3rd day of hospitalization was lower than that on the 1st day of hospitalization,and the difference was st

关 键 词：脓毒症相关性脑病 经颅多普勒 脑血流图 儿童 

分 类 号：R747.9[医药卫生—神经病学与精神病学] R720.597[医药卫生—临床医学]