新生儿缺氧缺血性脑病脑血流动力学变化及价值

目的 :研究缺氧缺血性脑病 (HIE)患儿脑血流动力学变化及血流频谱特点 ,并探讨其临床意义。方法 :运用彩色脉冲多普勒超声于生后 2 4小时内对 4 0例HIE患儿脑血流动力学参数进行了检测 ,并与 2 5例正常新生儿对照。结果 :HIE患儿存在显著的血流动力学紊乱 ,血流速度减慢 ,阻力指数增大 ,严重者舒张期无血流灌注 (即血流频谱呈单峰型 ) ,甚至舒张期逆灌注 ;少数患儿阻力指数降低 ,脑血流过度灌注。上述变化与病情程度和预后密切相关。结论 :运用脉冲多普勒超声检测脑血流动力学变化 ,可用于HIE的早期诊断、病情判断和预后评估 ,对指导治疗具有重要意义

The changes in cerebral hemodynamics in neonates with hypoxic-ischemic encephalopathy and their clinical significance in evaluation on judgment for severity and prognosis of the disease

Objective To learn changes in cerebral hemodynamics and characteristics of blood flow frequency spectrum of neonates with hypoxic-ischemic encephalopathy (HIE) and their clinical significance. Methods Using color Doppler ultrasonography to measure the cerebral hemodynamic parameters of 40 neonates with HIE and 25 healthy controls. Results The results shown that there were remarkable cerebral hemodynamic disorders in HIE, lowered blood flow velocity and increased resistance index, absence of blood flow perfusion during diastolic periods or inverse-perfusion in severe patients. Also, over-perfusion and decreased resistance index can be seen in the minority of patients. The changes mentioned above were closely associated with severity and prognosis of the disease. Conclusions It suggested that Doppler ultrasonography to monitor the changes in cerebral hemodynamics can be used for the early diagnosis and the judgment for severity and evaluation on prognosis of hypoxic-ischemic encephalopathy.