床旁颅脑超声鉴别诊断新生儿缺氧缺血性脑病的应用价值  

Clinical Value of Bedside Brain Ultrasound in Differential Diagnosis of Neonatal Hypoxic Ischemic Encephalopathy

作　　者：许逸 周敬勉 姚丽婷 XU Yi;ZHOU Jingmian;YAO Liting(Department of Ultrasound,Xiamen Hongai Hospital,Xiamen,Fujian,361000)

机构地区：[1]厦门弘爱医院超声科,福建厦门361000

出　　处：《智慧健康》2022年第34期18-21,共4页Smart Healthcare

摘　　要：目的探讨床旁颅脑超声鉴别诊断新生儿缺氧缺血性脑病的应用价值。方法选取2020年10月-2021年11月本院收治的62例缺氧缺血性脑病新生儿为研究组,并根据疾病严重程度分为轻度组(n=19)和中重度组(n=43)两个亚组,另选取同期62例健康新生儿为对照组,所有受试者均接受颅脑超声床旁监测,对比各组间出生24h、48h、72h的大脑前动脉收缩期及舒张期血流动力学指标。结果研究组出生24h、48h、72h的大脑前动脉收缩期峰值流速(PSV)明显低于对照组,差异有统计学意义(P<0.05);研究组出生24h、48h、72h的大脑前动脉舒张期流速(EDV)明显低于对照组,差异有统计学意义(P<0.05);研究组出生24h、48h、72h的大脑前动脉阻力指数(RI)明显高于对照组,差异有统计学意义(P<0.05)。中重度组患儿出生24h、48h、72h的PSV明显低于轻度组,差异有统计学意义(P<0.05);中重度组患儿出生24h、48h、72h的EDV明显低于轻度组,差异有统计学意义(P<0.05);中重度组患儿出生24h、48h、72h的RI明显高于轻度组,差异有统计学意义(P<0.05)。结论床旁颅脑超声实时监测可根据声像图变化明确新生儿脑血流变化情况,可早期识别新生儿缺氧缺血性脑病,并对病变程度进行有效评估,值得推广。Objective To explore the value of bedside brain ultrasound in differential diagnosis of neonatal hypoxic-ischemic encephalopathy.Methods 62 neonates with hypoxic-ischemic encephalopathy treated in our hospital from October 2020 to November 2021 were selected as the study group,and were divided into two subgroups:mild group(n=19)and moderate and severe group(n=43)according to the severity of the disease.Another 62 healthy newborns in the same period were selected as the control group.All subjects received bedside monitoring of brain ultrasound.The systolic and diastolic hemodynamic indexes of the anterior cerebral artery at 24h,48h and 72h of birth in each group were compared.Results The peak systolic velocity(PSV)of the anterior cerebral artery in the study group at 24h,48h and 72h after birth was significantly lower than that in the control group(P<0.05);The diastolic velocity(EDV)of the anterior cerebral artery in the study group at 24h,48h and 72h after birth was significantly lower than that in the control group(P<0.05);The resistance index(RI)of the anterior cerebral artery in the study group at 24h,48h and 72h after birth was significantly higher than that in the control group(P<0.05).The PSV at 24h,48h and 72h after birth in the moderate and severe group was significantly lower than that in the mild group(P<0.05);the EDV at 24h,48h and 72h after birth in the moderate and severe group was significantly lower than that in the mild group(P<0.05);the RI at 24h,48h and 72h in the moderate and severe group was significantly higher than that in the mild group(P<0.05).Conclusion Bedside brain ultrasound realtime monitoring can determine the changes of neonatal cerebral blood flow according to the changes of sonograms,can early identify neonatal hypoxic-ischemic encephalopathy,and effectively evaluate the degree of the disease,which is worth popularizing.

关 键 词：床旁颅脑超声 新生儿 缺氧缺血性脑病 血流动力学 血流改变 

分 类 号：R445.1[医药卫生—影像医学与核医学] R722.1[医药卫生—诊断学]