超声评估宫内窘迫早产儿头颅病变的价值

目的:比较一过性脑室周围回声增强(transient periventricular echodensities,TPE)、脑室周围白质损伤(periventricular leukomalacia,PVL)和脑出血在宫内窘迫(intrauterine growth restriction,IUGR)早产儿与无宫内窘迫早产儿中发病率的差异。方法:纳入孕24周～34周之间的IUGR早产儿和无IUGR早产儿各70例。入选病例分别在第3天、2周后及相当于足月时进行超声检查,评估TPE、PVL和出血性脑损伤在两组中发病的差异。结果:IUGR新生儿首次超声检查的TPE发病率增加(P<0.001),第二次和第三次超声检查的PVL发病率增加(P<0.001)。另外,首次超声检查对照组出血性脑损伤的发病率较高(P=0.004),第三次超声检查时,对照组的发病率降低,IUGR组则增加(P=0.015)。结论:IUGR可以引起早产儿脑白质损伤的发病率增加,有必要对此类早产儿进行常规超声随访。

Value of ultrasound for evaluating cerebral lesion in premature infants with intrauterine growth restriction

Objective:To compare the differences of incidences of transient periventricular echodensities(TPE),periventricular leukomalacia(PVL),and cerebral hemorrhage between premature infants with intrauterine growth restriction(IUGR) and premature infants without IUGR.Methods:Seventy premature infants with IUGR and seventy premature infants without IUGR at 24-34 gestational weeks were selected respectively.All the premature infants received ultrasonography on the third day,after two weeks,and at term-equivalent age,the differences of incidences of TPE,PVL,and cerebral hemorrhage between the two groups were evaluated.Results:Among the neonates with IUGR,the incidence of TPE detected by ultrasonography for the first time increased significantly(P<0.001),the incidences of PVL detected by ultrasonography for the second time and the third time increased significantly(P<0.001).The incidence of cerebral hemorrhage in control group detected by ultrasonography for the first time increased significantly(P=0.004),but the incidence decreased from the third time,while the incidence of cerebral hemorrhage in IUGR group increased significantly(P=0.015).Conclusion:IUGR can increased the incidence of white matter damage in premature infants,it is necessary to conduct routine follow-up for these premature infants by ultrasound.