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目的探讨三维超声在早产儿脑室内出血(IVH)中的应用价值。方法选择2011年4月-2012年2月本院NICU住院期间行床旁颅脑超声检查时发现IVH的早产儿,根据Papile分级法将IVH分为Ⅰ、Ⅱ、Ⅲ、Ⅳ级,检查时应用三维容积探头对出血部位进行扫描并存档,应用VOCAL软件对出血部位进行体积测量。结果Ⅰ级、Ⅱ级各20例无明显临床症状或神经精神症状轻,预后良好;Ⅲ级17例、Ⅳ级4例,表现为不同程度的神经精神症状,预后较差。Ⅰ、Ⅱ级表现为室管膜区及IVH,不引起脑室扩张;Ⅲ级表现为IVH并脑室扩张,Ⅳ级除Ⅲ级表现外,出现脑实质梗死出血。Ⅰ级出血体积0.03～1.35 cm3,Ⅱ级出血体积0.05～1.86 cm3,Ⅲ级出血体积3.10～17.44 cm3,Ⅳ级出血体积11.21～26.40 cm3。结论应用三维超声测量IVH体积将有利于了解出血部位与周边的关系,并成为评价患儿预后的标准之一。
Objective To investigate the value of three-dimensional ultrasound in intraventricular hemorrhage (IVH) in preterm infants. Methods April 2011 - February 2012 hospital NICU hospital bedside brain ultrasound examination found IVH preterm children, according to Papile grading IVH will be divided into Ⅰ, Ⅱ, Ⅲ, Ⅳ grade, check the application The three-dimensional volume probe scans and archives the bleeding site, and VOCAL software is used to measure the volume of the bleeding site. Results There were no significant clinical symptoms or neuropsychiatric symptoms in Grade Ⅰ and Grade Ⅱ patients, and the prognosis was good. Grade Ⅲ was 17 cases and Grade Ⅳ was 4 cases, showing neuropsychiatric symptoms with poor prognosis. Grade Ⅰ and Ⅱ showed ependymal zone and IVH, which did not cause ventricular dilatation. Grade Ⅲ showed IVH and ventricular dilatation. Grade Ⅳ manifested in addition to grade Ⅲ, with cerebral infarction. Ⅰ grade hemorrhage volume 0.03 ~ 1.35 cm3, Ⅱ grade hemorrhage volume 0.05 ~ 1.86 cm3, Ⅲ grade hemorrhage volume 3.10 ~ 17.44 cm3, Ⅳ grade hemorrhage volume 11.21 ~ 26.40 cm3. Conclusion The application of three-dimensional ultrasound to measure IVH volume will help to understand the relationship between the bleeding site and the periphery, and become one of the criteria for evaluating the prognosis of children.