新生儿缺血缺氧性脑病的CT随访研究

目的:研究新生儿缺血缺氧性脑病(HIE)的发展规律及程度与预后的关系。方法:收集有围产期窒息史,头颅CT诊断为不同程度的HIE,分别于3个月、6个月及1a进行CT和智力发育随访复查的患者51例。结果:3个月时50%病例有CT异常表现,大部分是外部性脑积水,其中27.3%病例有神经系统症状和体征;6个月复查,35.5%有CT异常表现,其中35.5%有神经系统症状和体征;1岁后约12.5%有异常CT表现,表现为局限性脑软化和脑萎缩。结论:HIE所致脑实质低密度影在出生后3个月内吸收消失;HIE的预后与CT分度密切相关,轻度预后良好。中、重度预后差。早产窒息儿颅内病变严重,如伴有脑实质出血,预后差;HIE在3个月复查时,50%有头颅CT表现异常,大部分为外部性脑积水,1岁时外部性脑积水愈合。

CT Follow-up Survey of Neonatal Hypoxic Ischemic Encephalopathy

Objective To study the evolution of neonatal hypoxic ischemic Encephalopathy(HIE). Methods 51 cases of asphyxial perinatal neonates were selected,and HIE was diagnosed on CT . Follow-up study was carried out at the 3rd, 6th month and one year of age. Results At 3rd month 50% cases were abnormal on CT, mostly showing externel hydrocephalus 27.3% cases had clinical manifestations of nervous system. At 6th, 35.5% cases were abnormal on CT.35.5% cases had clinical manifestations of nervous system. After one year,about 12.5% cases had abnormal CT with localiaed cerebral softening and atrophy , and corresponding clinical manifestationg. Conclusion Cerebral low density lesion was absorbed in 3 months; Prognosis of HIE was closely related to the degree of abnormal manifestations on CT. Intracranial lesions were more serious in asphyxial premature ones .If there were bleeding or bleeding in ventricles, the prognosis would be poor; At 3rd month, about half of the cases had abnormal CT, mostly showing extermely hydrocephalus (HE) .After one year, He was recovered.