经颅彩超在新生儿缺氧缺血性脑病中的应用价值

目的：分析经颅多普勒彩色超声在新生儿缺氧缺血性脑病( HIE）的诊断价值。方法：选取我院收治的45例HIE患儿为研究对象，及同期于我院生产的45例健康新生儿为对照组，所有新生儿均于出生后48 h内进行经颅多普勒彩超检查，分析其彩超结果及大脑中动脉附近血流动力学。结果：对照组新生儿脑沟及双侧脉络丛回声较强，脑实质组织回声中等，双侧基底节区回声较均匀。研究组24例轻度患儿脑实质回声均匀度较差，回声表现为略强小点状，16例中、重度患儿超声结果均显示其侧脑室出现狭窄，脑室旁白质回声增强。研究组新生儿Vs、Vd、Vm均显著低于对照组，差异具有统计学意义( P＜0.05）；中、重度组PI显著高于对照组( P＜0.05）；中、重度组RI＞0.72或≤0.55与对照组有统计学意义( P＜0.05）。结论：经颅彩超不仅可较为清晰的显示新生儿颅脑回声情况，还可有效的探测脑血流动力学的变化，为HIE的早期诊断提供丰富的参考数据支持，值得临床进一步实践。

The value of the application of transcranial Doppler color ultrasound in neonates with hypoxic-ischemic encephalopathy

Objective:To analyze the value of transcranial Doppler color ultrasound in the diagnosis of neonatal hypoxic-ischemic encephalopathy (HIE). Methods:Forty-ifve cases of neonates with HIE admitted to our hospital were selected as a study group and 45 cases healthy neonates at the same time were chosen as a control group. All the neonates were examined by transcranial Doppler color ultrasound within 48 hours after their birth and their examination results and the hemodynamics near the artery of brain were analyzed. Results:The echoes of the sulcus and bilateral choroid plexus, the brain parenchymal tissue and the bilateral basal ganglia were stronger, medium and more uniform in the control group, respectively. The brain parenchymal echo uniformity was poor in 24 cases of neonates with mild symptom, manifested as a little bit strong point and the ultrasound results from 16 cases with moderate to severe symptom showed a stenosis of the lateral ventricle with an enhanced echo of periventricular white matter in the study group. The Vs, Vd and Vm values of neonates were signiifcantly lower in the study group than in the control group (P<0.05). PI value in the neonates with moderate and severe symptom was signiifcantly higher than that in the control group (>0.72 vs≤0.55) (P<0.05). Conclusion:Transcranial Doppler color ultrasound can not only clearly show neonatal brain echo, but also effectively detect the changes in cerebral hemodynamics, which can provide abundant reference data support for the early diagnosis of HIE and is worthy of further clinical practice.