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目的研究足月新生儿缺氧缺血性脑病(HIE)患儿72 h内脑血流动力学的改变。方法应用彩色多普勒超声对90例确诊HIE患儿进行检查,分别于生后24 h内、生后(48±6)h、生后(72±6)h连续检测其大脑前动脉的收缩期峰值(Vs)、舒张末期速度(Vd)、阻力指数(RI)。与正常对照组比较,并予临床最终确诊HIE的程度进行对照分析。结果①脑血流速度的改变:生后24 h内轻度及中、重度HIE患儿的Vs、Vd均低于对照组(P<0.01?;轻度HIE患儿于生后(48±6)h脑血流速度与正常对照组比较差异无统计学意义(P>0.05),但中、重度HIE与正常对照组比较差异有统计学意义(P<0.01?。至生后(72±6)h脑血流参数测得均数差异均无统计学意义,但仍有5例异常,均为重度HIE。②血管阻力指数的变化:生后24 h内,无论是轻度HIE,还是中、重度HIE,RI均明显升高,至生后3 d接近正常对照组。结论 HIE患儿早期出现显著的脑血流动力学改变,动态监测HIE 72 h内脑血流动力学改变可作为早期评价脑损伤的重要指标。
Objective To investigate the changes of cerebral hemodynamics in infants with full-term neonatal hypoxic-ischemic encephalopathy (HIE) within 72 hours. Methods Ninety children with confirmed HIE were examined by color Doppler sonography. The contraction of the anterior cerebral artery was detected within 24 h after birth, after 48 ± 6 h and after 72 ± 6 h Peak (Vs), end-diastolic velocity (Vd), resistance index (RI). Compared with the normal control group, and to the degree of clinical final diagnosis of HIE for comparative analysis. Results ① The changes of cerebral blood flow velocity: The Vs and Vd of mild, moderate and severe HIE children were lower than those of the control group within 24 hours after birth (P <0.01? ) h There was no significant difference in cerebral blood flow velocity between normal control group and normal control group (P> 0.05), but there was significant difference between moderate and severe HIE and normal control group (P <0.01? ) h There was no significant difference in mean cerebral blood flow parameters between the two groups, but there were still 5 abnormalities, all of which were severe HIE.②Vascular resistance index changes: whether within 24 hours after birth, whether mild HIE or moderate , Severe HIE, RI were significantly increased, to 3 d after birth close to the normal control group.Conclusion Early cerebral hemorrhage in HIE patients showed significant changes in the dynamic monitoring of HIE within 72 h of cerebral hemodynamic changes can be used as early Evaluation of important indicators of brain injury.