频谱多普勒联合Apgar评分在新生儿缺氧缺血性脑病诊断中的应用

Applied value of the score of pulsed wave Doppler ultrasonography joint Apgar in diagnosis of hypoxic-ischemic encephalopathy

目的探讨床旁频谱多普勒技术联合Apgar评分在新生儿缺氧缺血性脑病(HIE)中应用的价值。方法将411例正常对照组新生儿及168例HIE组新生儿分为3个组(因小于28周胎龄出生的患儿例数少,暂不纳入研究范围),分别为大于38周胎龄出生,35~38周胎龄出生,28~35周胎龄出生,测量胼缘动脉、大脑中动脉的频谱多普勒参数峰值流速(Vmax)、舒张末流速(Vmin)、阻力指数(RI)及Apgar评分。结果大于38周胎龄出生、35~38周胎龄出生、28~35周胎龄出生的正常对照组与HIE组对比,Vmin及RI大部分差异有统计学意义(P<0.05),并随着出生时间的增加,正常对照组与HIE组RI均呈降低趋势,部分差异有统计学意义(P<0.05),Apgar评分差异均有统计学意义。结论频谱多普勒及Apgar评分均对新生儿HIE的早期诊断有应用价值,二者联合,可提高HIE早期诊断。

Objective To explore the applied value of bedside pulsed wave Doppler ultrasonography joint Apgar score in the diagnosis of hypoxic-ischemic encephalopathy(HIE). Methods A total of 411 normal newborn infants and 168 newborn infants with HIE were divided into three groups(newborn infants of gestational age of less than 28 weeks are not involved due to lack of enough cases): namely,the gestational age of over 38 weeks, gestational age of 35 to 38 weeks and gestational age of 28 to 35 weeks. Statistical analysis was done about the callosomarginal artery and middle celebral artery of peak flow velocity (Vmax), final diastolic velocity(Vmin) and resistance index(RI) of each group, including the 1 minute and 5 minutes of Apgar score. Results The contrasting data in Vmin and RI of the normally newborn infants and abnormally newborn infants in the other three groups were statistically significant( P < 0.05 ). As time passed by, RI of both normal infants and abnormal infants showed decrease tendency, part of which had statistical significance( P < 0.05 ), while the Apgar scores were all statistically significant( P < 0.05 ). Conclusion Pulsed wave Doppler ultrasonograhy and Apgar score are of great applied value in the diagnosis of hypoxic-ischemic encephalopathy in clinical treatment. The two combined, early diagnostic accuracy will be greatly improved.