中华围产医学杂志
中華圍產醫學雜誌
중화위산의학잡지
CHINESE JOURNAL OF PERINATAL MEDICINE
2013年
8期
489-492
,共4页
颅内出血%超声检查,多普勒,彩色%血流动力学%婴儿,新生
顱內齣血%超聲檢查,多普勒,綵色%血流動力學%嬰兒,新生
로내출혈%초성검사,다보륵,채색%혈류동역학%영인,신생
Intracranial hemorrhages%Ultrasonography,dopplor,color%Hemodynamics%Infant,newborn
目的 探讨颅内出血新生儿超声检查时的脑血流动力学变化. 方法 选择2010年12月1日至2012年6月30日于河南省安阳市妇幼保健院出生的61例通过新生儿早期超声影像学检查诊断的颅内出血新生儿作为病例组,根据超声检查结果对颅内出血的病情进行分级,并分为轻度和重度颅内出血组,分别为54例和7例.选择同期出生的50例健康新生儿作为对照组.采用多普勒超声仪对所有患儿大脑中动脉(middle cerebral artery,MCA)、大脑前动脉(anterior cerebral artery,ACA)颅内段的收缩期峰流速(peak systolic velocity,Vs)、舒张期末流速(end diastolic velocity,Vd)、平均流速(mean velocity,Vm)和阻力指数(resistance index,RI)等进行测定.统计学分析采用t检验. 结果 61例颅内出血患儿中,Ⅰ级12例(19.7％),Ⅱ级42例(68.9％),Ⅲ级6例(9.8％),Ⅳ级1例(1.6％).轻度颅内出血组和重度颅内出血组MCA和ACA的Vs、Vm和Vd均显著低于对照组,差异均有统计学意义[MCA:(55.1±9.1)cm/s,(53.0±6.5) cm/s与(60.1±10.3) cm/s; (34.2±6.1) cm/s,(32.5±5.2)cm/s与(38.2±6.9) cm/s; (17.1±4.8) cm/s,(15.3±4.0)cm/s与(20.2±5.3) cm/s. ACA:(41.3±11.7) cm/s,(39.4±9.2) cm/s与(45.3±9.8) cm/s;(25.2±5.8) cm/s,(23.3±4.9) cm/s与(28.1±5.9) cm/s;(15.0±3.9) cm/s,(13.2±3.1) cm/s与(15.9±3.8) cm/s,P均＜0.05]; RI均显著高于对照组,差异均有统计学意义(MCA:0.70±0.10,0.77±0.07与0.62±0.10; ACA:0.67±0.06,0.73±0.08与0.61±0.05;P均＜0.05).重度颅内出血组MCA和ACA的Vs、Vd和Vm均显著低于轻度出血组,RI显著高于轻度出血组,差异具有统计学意义(P均＜0.05). 结论 新生儿合并颅内出血时,超声检查MCA和ACA颅内段的血流有明显变化,重度颅内出血时变化更明显.
目的 探討顱內齣血新生兒超聲檢查時的腦血流動力學變化. 方法 選擇2010年12月1日至2012年6月30日于河南省安暘市婦幼保健院齣生的61例通過新生兒早期超聲影像學檢查診斷的顱內齣血新生兒作為病例組,根據超聲檢查結果對顱內齣血的病情進行分級,併分為輕度和重度顱內齣血組,分彆為54例和7例.選擇同期齣生的50例健康新生兒作為對照組.採用多普勒超聲儀對所有患兒大腦中動脈(middle cerebral artery,MCA)、大腦前動脈(anterior cerebral artery,ACA)顱內段的收縮期峰流速(peak systolic velocity,Vs)、舒張期末流速(end diastolic velocity,Vd)、平均流速(mean velocity,Vm)和阻力指數(resistance index,RI)等進行測定.統計學分析採用t檢驗. 結果 61例顱內齣血患兒中,Ⅰ級12例(19.7％),Ⅱ級42例(68.9％),Ⅲ級6例(9.8％),Ⅳ級1例(1.6％).輕度顱內齣血組和重度顱內齣血組MCA和ACA的Vs、Vm和Vd均顯著低于對照組,差異均有統計學意義[MCA:(55.1±9.1)cm/s,(53.0±6.5) cm/s與(60.1±10.3) cm/s; (34.2±6.1) cm/s,(32.5±5.2)cm/s與(38.2±6.9) cm/s; (17.1±4.8) cm/s,(15.3±4.0)cm/s與(20.2±5.3) cm/s. ACA:(41.3±11.7) cm/s,(39.4±9.2) cm/s與(45.3±9.8) cm/s;(25.2±5.8) cm/s,(23.3±4.9) cm/s與(28.1±5.9) cm/s;(15.0±3.9) cm/s,(13.2±3.1) cm/s與(15.9±3.8) cm/s,P均＜0.05]; RI均顯著高于對照組,差異均有統計學意義(MCA:0.70±0.10,0.77±0.07與0.62±0.10; ACA:0.67±0.06,0.73±0.08與0.61±0.05;P均＜0.05).重度顱內齣血組MCA和ACA的Vs、Vd和Vm均顯著低于輕度齣血組,RI顯著高于輕度齣血組,差異具有統計學意義(P均＜0.05). 結論 新生兒閤併顱內齣血時,超聲檢查MCA和ACA顱內段的血流有明顯變化,重度顱內齣血時變化更明顯.
목적 탐토로내출혈신생인초성검사시적뇌혈류동역학변화. 방법 선택2010년12월1일지2012년6월30일우하남성안양시부유보건원출생적61례통과신생인조기초성영상학검사진단적로내출혈신생인작위병례조,근거초성검사결과대로내출혈적병정진행분급,병분위경도화중도로내출혈조,분별위54례화7례.선택동기출생적50례건강신생인작위대조조.채용다보륵초성의대소유환인대뇌중동맥(middle cerebral artery,MCA)、대뇌전동맥(anterior cerebral artery,ACA)로내단적수축기봉류속(peak systolic velocity,Vs)、서장기말류속(end diastolic velocity,Vd)、평균류속(mean velocity,Vm)화조력지수(resistance index,RI)등진행측정.통계학분석채용t검험. 결과 61례로내출혈환인중,Ⅰ급12례(19.7％),Ⅱ급42례(68.9％),Ⅲ급6례(9.8％),Ⅳ급1례(1.6％).경도로내출혈조화중도로내출혈조MCA화ACA적Vs、Vm화Vd균현저저우대조조,차이균유통계학의의[MCA:(55.1±9.1)cm/s,(53.0±6.5) cm/s여(60.1±10.3) cm/s; (34.2±6.1) cm/s,(32.5±5.2)cm/s여(38.2±6.9) cm/s; (17.1±4.8) cm/s,(15.3±4.0)cm/s여(20.2±5.3) cm/s. ACA:(41.3±11.7) cm/s,(39.4±9.2) cm/s여(45.3±9.8) cm/s;(25.2±5.8) cm/s,(23.3±4.9) cm/s여(28.1±5.9) cm/s;(15.0±3.9) cm/s,(13.2±3.1) cm/s여(15.9±3.8) cm/s,P균＜0.05]; RI균현저고우대조조,차이균유통계학의의(MCA:0.70±0.10,0.77±0.07여0.62±0.10; ACA:0.67±0.06,0.73±0.08여0.61±0.05;P균＜0.05).중도로내출혈조MCA화ACA적Vs、Vd화Vm균현저저우경도출혈조,RI현저고우경도출혈조,차이구유통계학의의(P균＜0.05). 결론 신생인합병로내출혈시,초성검사MCA화ACA로내단적혈류유명현변화,중도로내출혈시변화경명현.
Objective To explore the hemodynamic changes in the brains of newborns with intracranial hemorrhage.Methods Totally,61 newborns,born in Anyang Maternal and Child Health Hospital of Henan Province,with intracranial hemorrhage diagnosed by ultrasound in early neonatal period,and 50 healthy newborns,also born in the same hospital from December 1,2010 to June30,2012,were selected.Intracranial hemorrhage newborns were graded according to the severity of hemorrhage and divided into mild (n=45) and severe groups (n =7).The peak systolic flow velocity (Vs),end diastolic velocity (Vd),mean flow velocity (Vm) and resistance index (RI) in the middle cerebral artery (MCA) and anterior cerebral artery (ACA) of brain were measured by Doppler ultrasound.Ttest was applied for statistical analysis.Results Among the 61 neonates with intracranialhemorrhage,12(19.7％) were grade Ⅰ,42(68.9％) were grade Ⅱ,6(9.8％) were grade Ⅲ,and one (1.6％) was grade Ⅳ.The Vs,Vm and Vd of MCA and ACA in the mild and severe intracranial hemorrhage group were significantly lower than those in the control group,the differences were statistically significant [MCA:(55.1±9.1) cm/s,(53.0±6.5) cm/s vs (60.1± 10.3) cm/s;(34.2±6.1) cm/s,(32.5±5.2) cm/s vs (38.2±6.9) cm/s; (17.1±4.8) cm/s,(15.3± 4.0) cm/svs (20.2±5.3) cm/s.ACA:(41.3±11.7) cm/s,(39.4±9.2) cm/s vs (45.3±9.8) cm/s;(25.2±5.8) cm/s,(23.3±4.9) cm/s vs (28.1±5.9) cm/s;(15.0±3.9) cm/s,(13.2±3.1) cm/s vs (15.9±3.8) cm/s,all P＜0.05].But the RI values were significantly higher in the control group,the differences were statistically significant (MCA:0.70 ± 0.10,0.77 ± 0.07 vs 0.62 ± 0.10 ; ACA:0.67±0.06,0.73±0.08 vs 0.61±0.05;all P＜0.05).TheVs,Vm and Vd of MCA and ACA in the severe intracranial hemorrhage group were significantly lower than in the mild hemorrhage group,while the RI values were significantly higher,and the differences were statistically significant (all P＜0.05).Conclusions Newborns with intracranial hemorrhage have significant hemodynamic changes in the brain and more prominent changes could be found in those with severe intracranial hemorrhage.
