床旁颅脑超声在早产儿脑损伤诊断中的应用.docVIP

床旁颅脑超声在早产儿脑损伤诊断中的应用 高昂 朱梅英 苏州市立医院新生儿科 X 关注成功！ 加关注后您将方便地在 我的关注中得到本文献的被引频次变化的通知！ 新浪微博 腾讯微博 人人网 开心网 豆瓣网 网易微博 摘????要： 目的 探讨床旁颅脑超声在早产儿脑损伤诊断中的应用价值。方法以2015年1月至2016年6月苏州市立医院NICU收治胎龄≤33周的早产儿529例为研究对象, 全部行床旁颅脑超声检查, 部分病例辅以头颅MRI或CT对照。结果 529例早产儿中, 脑损伤者302例 (其中B超检出298例, B超未检出4例, 后经MRI或CT检出) 。其中颅内出血272例, 早产儿脑白质损伤60例 (其中38例合并不同程度颅内出血) , 其他颅脑疾病14例。183例患儿经MRI或CT检出脑损伤56例, 除3例蛛网膜下腔出血及1例硬膜下出血B超未探及, 其余52例报告与B超相符。颅脑B超异常检出率为56.33% (298/529) , 显著高于头颅MRI及CT异常检出率30.60% (56/183) , 差异有统计学意义 (P0.05) 。颅内出血患儿脑白质损伤发生率为13.97% (38/272) , 显著高于非颅内出血患儿脑白质损伤发生率8.56% (22/257) , 差异有统计学意义 (P0.05) 。结论 早产儿脑损伤是动态变化的, 床旁颅脑超声在早期筛查及动态监测方面具有优越性, 可与头颅MRI及CT结合应用提高诊断准确性。 关键词： 脑损伤; 颅脑超声; 颅内出血; 脑白质损伤; 婴儿, 早产; 作者简介：高昂 (1978-) , 女, 副主任医师。研究方向:新生儿颅脑疾病及颅脑超声诊断E-mail:ang7859@ 收稿日期：2017-01-05 基金：江苏省妇幼保健科研项目 (F201410) Application of bedside cranial ultrasound in the diagnosis of brain injury in premature infants GAO Ang ZHU Meiying Department of Neonatology, Suzhou Municipal Hospital; Abstract： Objective To investigate the application value of bedside cranial ultrasound in the diagnosis of premature brain injury.Methods Totally 529 preterm infants with gestational age ≤33 weeks in NICU of Suzhou Municipal Hospital were included from January 2015 to June 2016.All of them were examined by bedside cranial ultrasound, and some of them were also examined by cranial MRI or CT as controls.Results There were 302 cases of brain injury, including 272 cases of intracranial hemorrhage, 60 cases of cerebral white matter injury (38 cases of them were combined with different degree of intracranial hemorrhage) , and 14 cases of other brain injury diseases.Totally 56 cases of brain injury were detected by MRI or CT in 183 preterm infants;3 cases of subarachnoid hemorrhage and 1 case of subdural hemorrhage were not detected by cranial ultrasound, and the other 52 cases were in accordance with cranial ultrasound report.The detection rate of cranial MRI and CT was 30.60% (56/183) .A total of 298 cases of brain injury were detecte