CAJ | 학술논문

目的通过检测围生期缺氧缺血事件新生儿高压氧(HBO)治疗前后的脑血流,了解高压氧治疗对有围生期缺氧缺血事件新生儿脑灌注的影响.方法于2008年12月-2010年12月在我院住院的有围生期缺氧缺血病史的新生儿中,随机选取30例,用彩色超声多普勒检测每次HBO治疗前后通过大脑中动脉(MCA)脑血流情况,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).所得数据采用SPSS 13.0统计软件进行统计分析.结果脑血流速度的改变:HBO治疗的第1、2天,治疗前后脑血流速度无明显改变;治疗第3天,Vs、Vd较前降低,其中Vs差异有显著性(P＜0.05),Vd差异有极显著性(P＜0.01);治疗第4天,Vs、Vd较前降低,Vs、Vd差异有极显著性(P＜0.01).血管阻力指数的变化:HBO治疗的第1、2天,无明显改变;治疗第3天,RI较前升高,RI差异有极显著性(P＜0.01);治疗第4天,RI较前升高,RI差异有极显著性(P＜0.01).结论对围生期缺氧缺血事件新生儿进行HBO治疗,初期脑灌注影响不明显,治疗后期产生明显影响,可使脑血管收缩并致血流速度减慢,从而影响脑灌注.
목적 통과검측위생기결양결혈사건신생인고압양(HBO)치료전후적뇌혈류,료해고압양치료대유위생기결양결혈사건신생인뇌관주적영향.방법 우2008년12월-2010년12월재아원주원적유위생기결양결혈병사적신생인중,수궤선취30례,용채색초성다보륵검측매차HBO치료전후통과대뇌중동맥(MCA)뇌혈류정황,련속검측기대뇌전동맥적수축기봉치(Vs)、서장말기속도(Vd)、조력지수(RI).소득수거채용SPSS 13.0통계연건진행통계분석.결과 뇌혈류속도적개변:HBO치료적제1、2천,치료전후뇌혈류속도무명현개변;치료제3천,Vs、Vd교전강저,기중Vs차이유현저성(P＜0.05),Vd차이유겁현저성(P＜0.01);치료제4천,Vs、Vd교전강저,Vs、Vd차이유겁현저성(P＜0.01).혈관조력지수적변화:HBO치료적제1、2천,무명현개변;치료제3천,RI교전승고,RI차이유겁현저성(P＜0.01);치료제4천,RI교전승고,RI차이유겁현저성(P＜0.01).결론 대위생기결양결혈사건신생인진행HBO치료,초기뇌관주영향불명현,치료후기산생명현영향,가사뇌혈관수축병치혈류속도감만,종이영향뇌관주.
Objective To observe the changes of cerebrovascular hemodynamics of newborn with perinatal period hypoxia ischemia which might lead to hypoxic-ischemic encephalopathy(HIE),and study the effects of hyperbaric oxygen (HBO) therapy effect.Methods Parameters of blood flow of middle cerebral artery (MCA) in anterior 60 neonates with perinatal hypoxia ischemia was measured by Color Doppler Ultrasonography,the neonates were enrolled from Dec.2008 to Jun.2010.60 cases were randomly divided into HBO group (n =30) and control group (n =30).Results ①Change of systolic peak velocity (Vs) and end-diastolic velocity (Vd):in all hemodynamic parameters,there were no obvious changes found,after the 1st and 2nd day' s therapy (P＞0.05).But Vs was significantly lower than that after 1st and 2nd day' s therapy (P＜0.05),Vd was significantly lower (P＜0.01) after the 3rd day' s treatment,and after the 4th day' s therapy,both Vs and Vd were highly significantly lower than those after the 1 st,the 2nd and the 3rd day's therapy(P＜0.01).②Change of resistence index (RI):after the 3rd and 4th day's treatment,RI was significantly higher (P＜0.01).Conclusions The anaphase of HBO treatment can lead to a decrease in cerebral blood flow and induces vasoconstriction in neonate with perinatal hypoxia ischemia,which might be in favor of the treatment for cerebral injury of HIE neonates.