脑电地形图和经颅多普勒超声对缺血缺氧性脑病患儿早期干预及预后评估的临床研究

The clinical study of early intervention and prognosis evaluation in newborn hypoxic ischemic encephalothy by brain electrical activity mapping and color transcranial doppler ultrasound

目的:探究早期判定新生儿缺氧缺血性脑病(HIE)所致脑血流低灌注量程度、脑细胞功能损伤程度及恢复情况,评估预后减少因过早终止治疗而出现的后遗症发生率。方法:采用16道脑电地形图仪(BEAM)和彩色经颅多普勒超声(TCD)对HIE患儿于初诊治疗前、出生后30 d、3个月、6个月、12个月以及24个月进行BEAM和TCD的检测。结果:BEAM对HIE患儿脑功能的评定具有特异性,尤其以恢复期的检测意义更为重要,TCD在急性重度HIE患儿存在严重的低灌注量,且低灌注程度与脑细胞损伤程度成正比。结论:新生儿期是中枢神经系统发育最迅速、可塑性最强及代偿能力最好的脑发育关键时期。BEAM和TCD应早期介入HIE的诊断、治疗及康复评定的全过程,侧重在恢复期的追踪,及时为临床提供科学信息,减少后遗症的发生。

Objective：The purpose is an earlier period to estimate the result that the low pour amount in brain blood flow, the degree of brain cell function injury and instauration circumstances and to reduce the linger effect outbreak rate resulting from over terminate the treatment early.Methods： The children with HIE were tested by the 16 channels of BEAM and TCD before treatment, and 30 days, the third month, the sixth month, the twelfth month and the 24 months after birth.Results： The BEAM gets the particularity to the HIE brain function assesses, especially more important in the convalescent period. TCD gets the heavy low perfusion at acute HIE seriously. The degree of the low pour is proportional to the degree of brain cell injury.Conclusion： The neonatal period is the most rapidly developed and the most plastic and the compensative ability is the best in the central nervous system. It is the best period of brain on growth. BEAM and TCD should get involved in the HIE diagnosis, treatment, recovery and assessment on the whole process in the earlier period. The focus is to track in the convalescent period, to provide clinical scientific information on time and to reduce linger effect.