围生期窒息新生儿脑损伤早期超声的临床诊断价值

Diagnostic value of cerebral ultrasound in early brain damage of asphyxia children in perinatal period

目的对围生期窒息病史的新生儿,72h内行床旁颅脑超声检查,观察脑组织结构及血流动力学改变,探讨此类患儿早期常见脑损伤类型及超声表现。方法方患儿出生后72h内行首次颅脑超声检查,多普勒技术经颞囟检测大脑前动脉、中动脉血流动力学变化,主要参数:收缩期峰值血流速度(Vs)、舒张末期血流速度(Vd)、阻力指数(RI)。结果生后72h内超声检查,60例患儿中47例表现不同程度的脑损伤,阳性率78.3%。结论围生期窒息患儿易造成缺氧缺血性脑损伤,颅脑超声可早期发现脑组织结构改变及血流动力学变化,72h内检查阳性率高,对NICU中的重症患儿,超声具有床旁检查的优势。

Objective In this work ,the newborn babies with the history of asphyxia in the perinatal period were subjec‐ted to the bedside cerebral ultrasound examination within 72 h .The brain structure and hemodynamic changes were ob‐served so as to early explore the the common type of brain injury and sonographic findings in these children .Methods Children born within 72 h underwent the bedeside cerebral ultrasound examination for the first time .The main parame‐ters ,which reflected the blood flow dynamic changes in anterior cerebral artery and middle cerebral artery ,in terms of the peak systolic blood flow velocity （Vs） ,end‐diastolic velocity （Vd） ,and resistance index （RI） ,were detected with doppler technique via temporal fontanelle .Results By the Ultrasound test within 72 h after birth ,47 out of 60 cases were shown brain injury at different extent .The positive rate was 78 .3% .Conclusion Children with asphyxia in the perinatal period are prone to hypoxic ischemic brain damage .Cerebral ultrasound can early detect the changes of brain tissue structure and hemodynamics .Checking within 72 h ,the positive rate is high .For the severe patients in NICU ,ultrasound has the ad‐vantages for bedside examination .