彩色多普勒超声在新生儿HIE中的血流动力学特征及与预后的关系

Hemodynamic characteristics of color Doppler ultrasound in neonates with HIE and its relationship with prognosis

目的探讨彩色多普勒超声在新生儿缺血缺氧性脑病(HIE)中的血流动力学特征及与预后的关系。方法以我院2018年11月至2020年11月新生儿科收治的115例HIE患儿为研究组,并选取同期47例健康新生儿为对照组。所有新生儿均行经颅彩色多普勒超声检查。比较新生儿出生后24、48、72 h时大脑中动脉(MCA)各血流动力学参数变化、侧脑室前角宽度与体部宽度、不同预后HIE患儿各血流动力学参数变化及新生儿脑实质超声图像。结果出生后24、48、72 h,研究组的Vs、Vd、Vm均显著低于对照组,RI显著高于对照组,且Vs、Vd、Vm随着研究组HIE分度的增加而降低,RI随着研究组HIE分度的增加而升高,差异具有统计学意义(P<0.05)。研究组患儿脑室左侧及右侧前角宽度与体部宽度均显著小于对照组,差异具有统计学意义(P<0.05)。预后不良组患儿的Vs、Vd、Vm均显著低于预后良好组,RI显著高于预后良好组,差异具有统计学意义(P<0.05)。结论在HIE患儿出生后不同时间采用彩色多普勒超声动态监测MCA各血流动力学参数对病情判断及预后评估具有积极意义。

Objective To investigate the hemodynamic characteristics of color Doppler ultrasound in neonates with hypoxic ischemic encephalopathy(HIE)and its relationship with prognosis.Methods A total of 115 children with HIE admitted in the neonatal department of our hospital from November 2018 to November 2020 were set as the study group,and 47 healthy newborns in the same period were selected as the control group.All the children were examined by transcranial color Doppler ultrasonography.The changes of hemodynamic parameters of middle cerebral artery(MCA)at 24,48 and 72 h after birth,the width of anterior angle and body of lateral ventriculum,the changes of hemodynamic parameters of the children with different prognosis of HIE and the ultrasonic images of the neonatal brain parenchyma were compared.Results At 24,48 and 72 h after birth,Vs,Vd and Vm in the study group were significantly lower than those in the control group,while RI was significantly higher than those in the control group,and Vs,Vd and Vm decreased with the increase of HIE degree in the study group,while RI increased with the increase of HIE degree in the study group,the differences were statistically significant(P<0.05).The widths of the left and right anterior angle and body of the ventricle in the study group were significantly smaller than those in the control group,and the differences were statistically significant(P<0.05).The Vs,Vd and Vm in the poor prognosis group were significantly lower than those in the good prognosis group,while RI was significantly higher than that in the good prognosis group,and the differences were statistically significant(P<0.05).Conclusion Dynamic monitoring of the hemodynamic parameters of MAC by color Doppler ultrasound at different time after the birth of HIE children has positive significance for the condition judgment and prognosis evaluation of the disease.