床旁多普勒超声检查在新生儿缺氧缺血性脑病的诊断和预后评估中的价值研究

目的 探讨床旁头颅超声检查在新生儿缺氧缺血性脑病（HIE）早期诊断中价值,分析其在HIE预后评估方面的临床意义.方法 采用床旁彩色多普勒超声仪对本院2012年1月——2014年3月有明确的可导致胎儿宫内窘迫的异常产科病史,以及严重的胎儿宫内窘迫表现、出生时重度窒息新生儿（HIE高危患儿）58例进行颅脑扫描检查,监测其72 h内脑血流变化,以同期66例健康新生儿作为对照,对数据统计分析.结果 HIE高风险患儿出生72h内脑血流存在显著改变,（48±3）h脑血流变化分析可用于早期诊断中、重度HIE,（72±3）h脑血流变化异常程度则与中、重度HIE存在线性相关关系.结论 应用床旁多普勒彩色超声检查对HIE高风险患儿进行出生72 h的脑血流动力学监测,可为HIE的早期诊断和干预治疗提供客观依据.

The study for diagnostic value and prognostic evaluation of bedside Doppler ultrasound examination to hypoxic-ischemic encephalopathy

Objective To investigate the early diagnostic value and prognostic evaluation of bedside Doppler ultrasound examination to hypoxic-ischemic encephalopathy （HIE） . Methods The intracranial vessels of 58 newborn infants with perinatal severe asphyxia from January 2012 to March 2014 were examined. Changes of cerebral blood flow within 72 hours were monitored, then data collection and statistical analysis to evaluate clinic value of bedside Doppler ultrasound examination to hypoxic- ischemic encephalopathy were analyzed. Results There was significantly change in cerebral blood flow of newborn infants with perinatal severe asphyxia within 72 hours. The analysis of changes of cerebral blood flow during （48 ± 3 ） hours might provide the basis for early diagnosis of middle and severe HIE. Abnormity degree of change of cerebral blood flow during （72 ± 3） hours linearly related to middle and severe HIE. Conclusion Monitoring the change of cerebral blood flow of newborn infants with perinatal severe asphyxia bedside Doppler ultrasound within 72 by hours might provide the basis for early diagnosis of middle and severe HIE. Also it could be the reliable methods of prognostic evaluation for HIE.