颅脑超声在新生儿脑室周围-脑室内出血中的应用  

The application of cranial ultrasonography on periventricular-intraventricular hemorrhage in neonates

作　　者：姚文[1] 郑慧[1] 刘云 Yao Wen;Zheng Hui;Liu Yun(Dept of Ultrasound,The First Affiliated Hospital of Anhui Medical University,Hefei 230022)

机构地区：[1]安徽医科大学第一附属医院超声科,合肥230022

出　　处：《安徽医科大学学报》2022年第11期1835-1838,共4页Acta Universitatis Medicinalis Anhui

基　　金：安徽省公益性研究联动计划项目(编号:1604f0804027)。

摘　　要：目的探讨颅脑超声(CUS)检查在新生儿脑室周围-脑室内出血(PIVH)中的诊断价值,并分析PIVH的危险因素。方法以医院新生儿科行床边CUS的156例新生儿为研究对象,总结CUS影像学特点,采用χ2检验分析围生期临床参数与PIVH发生率的关系,采用Logistic回归模型分析PIVH发生的危险因素。结果PIVH的CUS影像主要表现为室管膜区和脑室内高回声灶,大量出血时可表现为脑室增宽和脑实质内高回声灶。156例新生儿经CUS诊断PIVH共计49例(31.4%),其中轻度PIVH(Ⅰ、Ⅱ级)发生率为28.8%,重度PIVH(Ⅲ、Ⅳ级)发生率为2.6%。低出生胎龄、低出生体质量、3 min Apagar评分<7分、呼吸窘迫、肺炎和败血症的新生儿的PIVH的发生率较高,差异均有统计学意义(P<0.05)。经多因素Logistic回归分析,低出生胎龄是新生儿发生PIVH的独立危险因素(OR=0.783,95%CI:0.639~0.959,P=0.018)。结论床边CUS对新生儿PIVH有较高的诊断价值,低出生胎龄、低出生体质量及伴有引发脑组织乏氧相关合并症的新生儿发生PIVH的风险较高,应作为重点筛查对象。Objective To investigate the value of cranial ultrasonography in the diagnosis of periventricular-intraventricular hemorrhage(PIVH)and analyze the risk factors of PIVH in neonates.Methods 163 neonates hospitalized in the neonatal intensive care unit were examined by bedside cranial ultrasonography(CUS),The ultrasonography of PIVH were reviewed and analyzed.Chi-square test was used to study the correlations between perinatal parameters and the morbidity rate of PIVH.Logistic regression analysis was used to detect the risk factor of PIVH.Results Ultrasonography of PIVH was characterized by hyperechoic masses in germinal matrix and ventricles,whereas in severe cases,ventricular dilatation and hyperechoic foci in the brain parenchyma could be scanned.Among 156 neonates,49 cases(31.4%)were diagnosed with PIVH by CUS,including 45 cases(28.8%)of mild PIVH(gradeⅠandⅡ)and 4 cases(2.6%)of severe PIVH(gradeⅢandⅣ).There were statistically higher incidence of PIVH in neonates with low gestational age,low birth weight,3 min Apagar score<7,respiratory distress syndrome,pneumonia and sepsis,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that low gestational age was an independent risk factor for PIVH(OR=0.783,95%CI:0.639-0.959,P=0.018).Conclusion CUS is a reliable examination method to the diagnosis and grading of PIVH.CUS screening is essential to susceptible neonates with low gestational age,low birth weight and hypoxia related complications.

关 键 词：新生儿 脑室周围-脑室内出血 颅脑超声 

分 类 号：R722.1[医药卫生—儿科]