新生儿缺氧缺血性脑病的超声诊断价值
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摘要
目的:分析新生儿缺氧缺血性脑病(HIE)的超声诊断价值。方法:随机选取100例HIE患儿纳入观察组,同期选取100名健康新生儿纳入健康对照组。两组新生儿均在出生24 h内接受第1次床旁经颅超声检查,且须在72 h内进行第2次检查。观察组患儿在使用脱水剂治疗后第2 d进行复查,观察新生儿收缩峰值血流速度(Vs)、平均血流速度(Vm)值并观察患儿颅内超声表现。结果:观察组新生儿在出生24 h和72 h的Vs、Vm值大于健康对照组,差异有统计学意义(t=16.203,t=23.032;P<0.05),24 h的Vd值小于健康对照组,72 h高于健康对照组,差异有统计学意义(t=5.399,t=25.698;P<0.05);阻力指数(RI)在24 h大于健康对照组,而在72 h小于健康对照组,差异有统计学意义(t=22.188,t=13.240;P<0.05)。观察组超声图像显示患儿颅内结构清晰,脑中线居中。24 h检查发现25.00%的患儿表现出侧脑室体部-后角周围脑白质显示回声增强,强于脉络丛回声;45.00%侧脑室外缘不清,55.00%表现不明显。72 h第2次检查发现,98.00%的患儿出现双侧脑半球回声弥漫性增强,94.00%脑沟显示模糊,灰白界限不清,双侧脑室变窄。结论:颅脑超声能实时反映HIE患儿脑灌注情况,判断脑主干血管收缩,与超声影像学特点相结合,有利于诊断HIE。
Objective: To analyze the value of ultrasonic diagnosis for hypoxic ischemic encephalopathy(HIE).Methods: A total of 100 children with HIE were randomly included into the observation group, and 100 healthy newborns in the same period were included into the healthy control group. Both groups of newborns received the first examination bedside transcranial ultrasound within 24 hours of birth and the second examination should be within 72 hours. Children of observation group underwent reexamination at the 2 nd day post treatment with dehydrating agent,and the blood flow velocity(Vs) of shrinkage peak value of neonates, average blood flow velocity(Vm) of neonates and the intracranial ultrasound findings of children with HIE were observed. Results: The Vs and Vm values of the newborns of the observation group at 24 h and 72 h were significantly higher than those in the healthy control group at the same times(t=16.203, t=23.032, P<0.05). The Vd value of observation group at 24 h was significantly lower than that in healthy control group, and one of observation group at 72 h was significantly higher than that of healthy control group at the same time(t=5.399, t=25.698, P<0.05). The RI of observation group was significantly higher than that of healthy control group at 24 h, but significantly less than that of healthy control group at 72 h(t=22.188,t=13.240, P<0.05). The ultrasound images of observation group showed that the intracranial structure of the children were clear and the brain midline of them were middle. The results of 24 h examination indicated that 25.00% of the children showed echo enhancement in the white matter around the body-posterior horn of the lateral ventricle, and it was stronger than the choroid plexus echo. And 45.00% of the outer edge of lateral ventricle was unclear, and 55.00%of their performance was not obvious. The second examination at 72 h found that 98.00% of the children had diffuse enhancement of bilateral hemisphere echoes, 94.00% of the sulus was blurred, and their gray boundaries was unclear,and bilateral ventricles narrowed. Conclusion: Craniocerebral ultrasound can reflect the cerebral perfusion of children with HIE in real time, and can determine the contraction of the vasculature of brain stem. And combined with the characteristics of ultrasound imaging, it is conducive to the diagnosis of HIE.
Objective: To analyze the value of ultrasonic diagnosis for hypoxic ischemic encephalopathy(HIE).Methods: A total of 100 children with HIE were randomly included into the observation group, and 100 healthy newborns in the same period were included into the healthy control group. Both groups of newborns received the first examination bedside transcranial ultrasound within 24 hours of birth and the second examination should be within 72 hours. Children of observation group underwent reexamination at the 2 nd day post treatment with dehydrating agent,and the blood flow velocity(Vs) of shrinkage peak value of neonates, average blood flow velocity(Vm) of neonates and the intracranial ultrasound findings of children with HIE were observed. Results: The Vs and Vm values of the newborns of the observation group at 24 h and 72 h were significantly higher than those in the healthy control group at the same times(t=16.203, t=23.032, P<0.05). The Vd value of observation group at 24 h was significantly lower than that in healthy control group, and one of observation group at 72 h was significantly higher than that of healthy control group at the same time(t=5.399, t=25.698, P<0.05). The RI of observation group was significantly higher than that of healthy control group at 24 h, but significantly less than that of healthy control group at 72 h(t=22.188,t=13.240, P<0.05). The ultrasound images of observation group showed that the intracranial structure of the children were clear and the brain midline of them were middle. The results of 24 h examination indicated that 25.00% of the children showed echo enhancement in the white matter around the body-posterior horn of the lateral ventricle, and it was stronger than the choroid plexus echo. And 45.00% of the outer edge of lateral ventricle was unclear, and 55.00%of their performance was not obvious. The second examination at 72 h found that 98.00% of the children had diffuse enhancement of bilateral hemisphere echoes, 94.00% of the sulus was blurred, and their gray boundaries was unclear,and bilateral ventricles narrowed. Conclusion: Craniocerebral ultrasound can reflect the cerebral perfusion of children with HIE in real time, and can determine the contraction of the vasculature of brain stem. And combined with the characteristics of ultrasound imaging, it is conducive to the diagnosis of HIE.
引文
[1]孙冰,古治梅,张刚,等.新生儿缺血缺氧性脑病67例的CT和磁共振成像表现[J].山西医药杂志,2018,47(3):271-273.
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[8]王月怡,沈文莉,高彩云,等.振幅整合脑电图在新生儿缺氧缺血性脑病早期诊治及预测预后中的应用价值[J].临床和实验医学杂志,2017,16(12):1227-1230.
[9]霍亚玲,郑彬,王丹,等.彩色多普勒超声对新生儿缺氧缺血性脑病的诊断价值[J].中国超声医学杂志,2018,14(2):101-104.
[10]程可萍,朱品俐,王艳维.振幅整合脑电图在新生儿缺氧缺血性脑病中的诊断价值探讨[J].中华全科医学,2016,14(4):612-614.
[11]姬星,景赟杭,闫军,等.新生儿缺血缺氧性脑病29例CT、MR成像对照分析[J].陕西医学杂志,2016,45(11):1474-1475.
[12]胡龙非,陈光真,姜燕,等.新生儿缺氧缺血性脑病CT诊断特点与临床表现分析[J].中国CT和MRI杂志,2016,14(10):23-26.
[13]马超,刘春枝.新生儿缺氧缺血性脑病诊治进展[J].内蒙古医科大学学报,2016,12(1):71-79.
[14]陈立平,柏天军,庞善军,等.磁共振成像和磁共振波谱对新生儿缺氧缺血性脑病预后的早期诊断价值及预后评估[J].中国妇幼保健,2016,31(16):3407-3409.
[15]崔军建,赵鑫,张小安,等.CT及MRI诊断新生儿缺氧缺血性脑病的价值[J].中国实用医药,2016,11(28):78-79.
[2]杜晓宁,崔彦存,严慧芳,等.动态脑电图对比CT检查在评估新生儿HIE中的临床效果[J].贵州医药,2016,40(7):769-770.
[3]王海艳,王丽艳,王娜,等.血清胱抑素C对新生儿缺氧缺血性脑病早期肾损伤的诊断价值分析[J].检验医学与临床,2017,14(19):2917-2918.
[4]包克珍,黄勇,胡晓泽,等.新生儿缺氧缺血性脑病危险因素及预后分析[J].中国妇幼保健,2016,31(5):971-973.
[5]曾玲.新生儿缺氧缺血性脑病发病及预后影响因素分析[J].新乡医学院学报,2017,34(4):313-315.
[6]鲁旭,姜泓,张渊韬.新生儿缺氧缺血性脑病发病机制研究进展[J].新乡医学院学报,2016,33(10):927-929.
[7]邹博,姜双全,于丹丹,等.新生儿缺氧缺血性脑病的灰阶及CDFI参数定量研究[J].中国超声医学杂志,2016,32(5):385-388.
[8]王月怡,沈文莉,高彩云,等.振幅整合脑电图在新生儿缺氧缺血性脑病早期诊治及预测预后中的应用价值[J].临床和实验医学杂志,2017,16(12):1227-1230.
[9]霍亚玲,郑彬,王丹,等.彩色多普勒超声对新生儿缺氧缺血性脑病的诊断价值[J].中国超声医学杂志,2018,14(2):101-104.
[10]程可萍,朱品俐,王艳维.振幅整合脑电图在新生儿缺氧缺血性脑病中的诊断价值探讨[J].中华全科医学,2016,14(4):612-614.
[11]姬星,景赟杭,闫军,等.新生儿缺血缺氧性脑病29例CT、MR成像对照分析[J].陕西医学杂志,2016,45(11):1474-1475.
[12]胡龙非,陈光真,姜燕,等.新生儿缺氧缺血性脑病CT诊断特点与临床表现分析[J].中国CT和MRI杂志,2016,14(10):23-26.
[13]马超,刘春枝.新生儿缺氧缺血性脑病诊治进展[J].内蒙古医科大学学报,2016,12(1):71-79.
[14]陈立平,柏天军,庞善军,等.磁共振成像和磁共振波谱对新生儿缺氧缺血性脑病预后的早期诊断价值及预后评估[J].中国妇幼保健,2016,31(16):3407-3409.
[15]崔军建,赵鑫,张小安,等.CT及MRI诊断新生儿缺氧缺血性脑病的价值[J].中国实用医药,2016,11(28):78-79.