彩色多普勒检测围产儿脐动脉及大脑中动脉血流在诊断新生儿脑损伤的临床价值

Clinical value of color Doppler examination of the blood flow of UA and cerebral MCA of perinatal infant in diagnosing cerebral injury of newborn

目的:研究彩色多普勒检测围产儿脐动脉(UA)及大脑中动脉(MCA)血流对新生儿脑损伤的诊断价值。方法:选取医院收治的70例新生儿脑损伤患儿,将其纳入脑损伤组,同期选取70名正常新生儿,将其纳入健康对照组,两组均于围产期接受彩色多普勒检测,按照《新生儿缺氧缺血性脑病诊断标准》将脑损伤组再分为重度组(15例)、中度组(25例)和轻度组(30例)。观察彩色多普勒检测对新生儿脑损伤检出率及诊断准确率,比较脑损伤组与健康对照组围产期UA收缩压/舒张压(S/D)、阻力指数(RI)、搏动指数(PI)和MCA的RI、PI。结果:在70例脑损伤患儿中,彩色多普勒共检出62例,检出率为88.57%,准确率为85.71%;UA的S/D、RI及PI值中,重度组>中度组>轻度组>对照组,脑损伤3组与对照组比较差异有统计学意义(F=499.507,F=100.865,F=58.597;P<0.05);MCA的RI、PI值中,重度组<中度组<轻度组<对照组,脑损伤3组与对照组比较,差异有统计学意义(F=22.765,F=35.530,P<0.05)。结论:彩色多普勒对新生儿脑损伤诊断具有较高准确率,围产儿UA与MCA血流参数与新生儿脑损伤情况具有紧密联系,临床通过其检测,可为新生儿脑损伤诊断提供可靠依据。

Objective:To evaluate the diagnostic value of color Doppler examination of the blood flow of umbilical artery(UA)and cerebral middle cerebral artery(MCA)of perinatal infant in diagnosing cerebral injury of newborn.Methods:70 newborns with cerebral injury who were divided into cerebral injury group and 70 normal newborns who were divided into healthy control group were enrolled in this study.Both two groups underwent color Doppler examination during perinatal period.According to<Diagnostic Criteria for Neonatal Hypoxic-ischemic Encephalopathy>,the cerebral injury group were further divided into severe group(15 cases),moderate group(25 cases)and mild group(30 cases).The detection rate and diagnostic accuracy rate of color Doppler for cerebral injury of newborns were observed.The systolic blood pressure/diastolic blood pressure(S/D),resistive index(RI)and pulsatility index(PI)of perinatal UA,the RI and PI of perinatal MCA between the two groups were compared.Results:In 70 newborns with cerebral injury,total of 62 cases with cerebral injury were detected by color Doppler which detection rate was 88.57%and accuracy rate was 85.71%.In the comparison of S/D,RI and PI of UA,the severe group was larger than moderate group which was larger than mild group which was larger than control group.And the differences of cerebral injury among the three groups and control group were significant(F=499.507,F=100.865,F=58.597,P<0.05).In the comparisons of RI and PI of MCA,the sever group was less than moderate group,which was less than mild group which was less than control group.The differences of cerebral injury among three groups and control group were significant(F=22.765,F=35.530,P<0.05).Conclusion:Color Doppler has higher accuracy rate in the diagnosis of cerebral injury of newborn.The blood flow parameters of UA and MCA of perinatal infant are closely related to cerebral injury of newborn.Clinical detection of the above parameters can provide a reliable basis for diagnosis of cerebral injury of newborn.