彩色多普勒超声应用于新生儿缺氧缺血性脑病的临床价值(1)
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[摘要] 目的：应用彩色多普勒超声研究新生儿缺氧缺血性脑病(HIE)的颅内脑血流动力学及颅内结构改变特征。方法：对40例临床诊断为HIE的住院新生儿在出生后24、48和72 h连续3次进行彩色多普勒超声检查，观察患儿脑实质回声变化及脑血流动力学改变。对照组为48例健康足月新生儿。结果：不同程度的HIE组新生儿出生后24 h脑实质回声呈点状或小片状，或广泛回声增强，出生后48 h轻度HIE组脑实质回声趋于正常，中、重度HIE组出生后48~72 h脑实质回声仍呈散在回声增强。出生后72 h内存在脑血流显著改变，主要表现为脑血流速度减慢，阻力指数升高。在出生后24～72 h内脑血流动力学参数有不同程度的恢复。结论：彩色多普勒超声可以作为早期诊断HIE的实用、方便的重要检测方法，对指导临床医师治疗及评估预后具有重要价值。
[关键词] 彩色多普勒超声；缺氧缺血性脑病；新生儿
[中图分类号] R722[文献标识码]A [文章编号]1673-7210(2009)05(c)-020-03
Clinical value of color Doppler ultrasonography in the treatment of neonatal hypoxic ischemic encephalopathy
LI Jiaping, YANG Shimei, QIU Dong, LONG Jinsong, WU Yuzhen, CHEN Mingyu
(Department of Ultrasound, the Sixth Hospital of Shenzhen City, Shenzhen 518052, China)
[Abstract] Objective: To study the changes of cerebrovascular and cerebral parenchymal of neonatal hypoxic ischemic encephalopathy (HIE) by the color Doppler ultrasonographic (CDUS). Methods: The changes of cerebral parenchymal and cerebral arterial blood stream parameter in 40 cases of neonates clinically diagnosed as HIE and 48 cases of normal newborns on the 24, 48 and 72 hours after birth were observed by CDUS. Results: The cerebral parenchyma was maldistributed and reinforced in mild asphyxia neonates and it was more serious in different degrees. The echo of cerebral parenchyma in mild degree was near normal 48 hours after birth, while the echo of cerebral parenchyma in moderate degree was still maldistributed and reinforced 48 and 72 hours after birth. There was obvious changes in the cerebral arterial blood stream parameter and hemodynamics of the asphyxia newborns 72 hours after birth. The velocity of the cerebralarteries were obviously lower than that of control group. Resistance index of the cerebral arteries was higher than that of control group, and the cerebral arterial blood stream parameter and hemodynamics were recovered to different degrees between 24 and 72 hours. Conclusion: CDUS is a convenient and noninvasive method for early diagnosis of HIE ......
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