新生儿缺氧缺血性脑病行为神经测定与临床、头颅CT表现关系探讨

Relations between behavioral neuroligical assessment and clinical,coronal-CT manifestions in neonatal hypoxic ischemic encephalopathy

目的 :探讨新生儿缺氧缺血性脑病 (HIE)行为神经测定 (NBNA)与临床、头颅CT的关系。方法 :对 96例HIE患儿进行动态 2 0项NBNA评分 ,并与临床分度、头颅CT分度比较。结果 :第 5～ 7天临床、头颅CT愈重 ,NBNA评分异常率愈高(P <0 .0 1和P <0 .0 0 5 ) ;第 12～ 14天临床轻中度患儿NBNA评分恢复正常率明显高于重度患儿 ,其中轻度恢复更明显 (P <0 .0 0 5 ) ;第 2 4～ 2 8天轻中度患儿NBNA评分可进一步恢复 (P <0 .0 0 5 )。第 4周头颅CT检查 9例异常者 ,NBNA均低于 35分 (P <0 .0 0 5 ) ,临床随访均有不同程度的后遗症。结论

Objective:To investigate the relations between behavioral neuroligical assessment and clinical,coronal CT manifestions in neonatal hypoxic ischemic encephalopathy(HIE).Methods:Ninety six cases of HIE were graded by 20 items of NBNA,which was compared with the clinical and coronal CT manifestations.Results:From 5 to 7 days the more severe the clinical and coronal CT manifestations were the lower the NBNA grades would be( P <0.01 and P <0.005).From 12 to 14 days NBNA grade increased more manificantly in mild and moderate patients than in severe patients( P <0.005) and increased farther from 24 to 28 days( P < 0.005 ).The 9 patients whose grade of NBNA was lower than 35 points( P <0.005) and whose coronal CT manifestations abnormal after 4 weeks all had sequel as to some extent.Conclusions:Dynamic NBNA helps to estimate the severity and prognosis of HIE.