早产儿窒息早期脑血流动力学变化及意义

Changes of cerebrovascular hemodynamics in asphyctic preterm infants in the early days and their signification

目的探讨窒息早产儿出生后72 h内脑血流动力学变化特点。方法应用彩色多普勒超声对临床诊断为窒息的早产儿48例,于生后24、48、72 h测量其大脑前、中、后动脉的收缩期血流速度(Vs)、平均血流速度(Vm)、舒张末期血流速度(Vd)及阻力指数(RI),并与无窒息史的正常早产儿20例进行比较。结果与对照组比较,窒息患儿各大脑动脉不同程度流速降低和阻力指数升高,窒息越重,脑血流速度降低及阻力指数升高的幅度越大、持续时间越久。结论应用彩色多普勒超声观察窒息早产儿脑血流动力学变化,发现患儿生后72 h内脑血流动力学变化显著,变化程度与窒息程度密切相关。

Objective To study the changes of cerebrovascular hemodynamics in asphyctic preterm infants within 72 hours after birth. Methods The cerebral arterial blood stream parameter of 48 preterm infants clinically diag- nosed asphyxia and of 20 normal newborns were observed by color Doppler ultrasonography 24,48 and 72 hours af- ter birth. Results Compared with normal newborns, asphyctic preterm infants showed a decrease of blood flow ve- locity and resistance index increased to varying degrees, and when the degree of asphyxia was more serious, the changes were more obvious and sustained longer. Conclusion preterm infants＇ cerebrovascular hemodynamics shows significant related to the degree of asphyxia. Doppler ultrasonographic assessment of asphyctic changes within 72 h after birth, which is closely