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目的 了解出生时重度窒息新生儿的脑血流速度变化及其与新生儿缺氧缺血性脑病 (HIE)程度之间的关系。方法 采用经颅多普勒超声对重度窒息新生儿于复苏后 2 4小时内及 72小时内分两次进行脑血流速度检测。根据发生HIE的程度分为中重度组、轻度组与对照组分别进行比较。结果 重度窒息所致HIE患儿 2 4小时内大脑中动脉的脑血流速度减慢 ,搏动指数 (PI)及阻力指数 (RI)增加 ,大脑前动脉的上述值在HIE中重度组改变明显 ,轻度组左侧大脑前动脉的PI与对照组相比无显著差异。两组HIE患儿之间大脑中动脉的平均血流速度 (Vm)、PI、RI及大脑前动脉的PI在 72小时内有所恢复 ,但中重度组患儿大脑前动脉的Vm及RI与轻度组之间有显著性差异。结论 重度窒息患儿出生后 2 4小时内脑血流速度减慢 ,脑灌注减少 ,如果脑血流速度尤其是大脑前动脉的Vm、RI 72小时不能完全恢复 ,则提示脑的缺血性损伤较重
Objective To investigate the changes of cerebral blood flow velocity in neonates with severe asphyxia at birth and its relationship with the degree of neonatal hypoxic-ischemic encephalopathy (HIE). Methods The transcranial Doppler echocardiography was used to detect the cerebral blood flow velocity in 24 hours and 72 hours after resuscitation in neonates with severe asphyxia. According to the degree of occurrence of HIE moderate to severe group, mild group and control group were compared. Results The cerebral blood flow velocity of middle cerebral artery was slowed down within 24 hours in HIE infants with severe asphyxia, and the PI and RI were increased. The values of the anterior cerebral artery in HIE moderate-severe group changed obviously, There was no significant difference in PI of the left anterior cerebral artery in the mild group compared with the control group. Mean arterial flow velocity (Vm), PI, RI and PI in the anterior cerebral artery in two HIE children recovered within 72 hours. However, Vm and RI of the anterior cerebral artery in children with HIE and There was a significant difference between mild groups. Conclusion Severe asphyxia in children within 24 hours after birth slowed down the cerebral blood flow, decreased cerebral perfusion, if the cerebral blood flow velocity, especially in the anterior cerebral artery Vm, RI 72 hours can not be fully restored, suggesting cerebral ischemic injury Heavier