大脑中动脉中央支血流动力学评价新生儿缺血缺氧性脑病.PDFVIP

J South Med Univ, 2014, 34(8): 1199-1202 doi 10.3969/j.issn. 1673-4254.2014.08.26 ·1199 · 临床研究 大脑中动脉中央支血流动力学评价新生儿缺血缺氧性脑病大脑中动脉中央支血流动力学评价新生儿缺血缺氧性脑病 王 娜，张遇乐，关步云 广州市妇女儿童医疗中心超声科，广东 广州 510120 摘要：目的探讨新生儿缺血缺氧性脑病（HIE）不同时期大脑中动脉中央支血流动力学变化及其相互关系，为临床诊断HIE 提供 新的参考依据。方法 将2013 年3~7 月在我中心儿童院区临床确诊为HIE 的136例患儿作为实验组，进行二维超声检查并应用 彩色多普勒超声测定大脑中动脉中央支收缩期血流速度（Vs）及阻力指数（RI），与作为对照组的251 例正常足月儿的大脑中动脉 中央支声像图比较，并对血流参数进行统计分析。结果 实验组超声声像图显示轻度HIE 患儿脑水肿仅脑室周围白质增强，中、 重度HIE 患儿出现双侧脑半球回声弥漫性增强，脑结构回声模糊，清晰度降低。实验组轻度、中度和重度HIE 患儿脉冲多普勒 检测大脑中动脉中央支血流动力学与对照组比较，表现为Vs 降低，RI 升高，与对照组比较均有统计学意义（P0.05），且轻度与 中、重度HIE 患儿之间Vs和RI 比较有显著差异（P0.05），中度与重度HIE 患儿之间Vs和RI 比较无显著差异（P0.05）。结论 超 声检查能够动态观察HIE 患儿颅内二维形态、回声改变及脑血流灌注特点，大脑中动脉中央支能够清晰准确反映患儿脑血流灌 注情况，为早期诊断脑水肿，早期进行临床干预提供有价值的依据。 关键词：缺血缺氧性脑病；大脑中动脉；中央支；脑血流参数；超声检查 Evaluation of neonatal hypoxic-ischemic encephalopathy by ultrasound measurement of the hemodynamics in the central branches of the middle cerebral artery WANG Na, ZHANG Yule, GUAN Buyun Department of Ultrasound, Guangzhou Women and Childrens Medical Center, Guangzhou 510120, China Abstract: Objective To evaluate the hemodynamic changes in the central branches of the middle cerebral artery in different stages of neonatal hypoxic-ischemic encephalopathy (HIE) and provide new evidence for clinical diagnosis of HIE. Methods From March, 2013 to July, 2013, a total of 136 newborn infants were diagnosed to have HIE in our center. We performed two-dimensional ultrasonography and color Doppler ultrasound for assessments of systolic velocity (Vs) and resistant index (RI) of the central branches of the middle cerebral artery. The data were compared with the results of a control group consisting of 251 normal full-term infants. Results Infants with mild HIE showed hyperechoic changes in the white matter around the ventricle, while in moderate and severe