摘要
目的探讨颅脑超声在新生儿颅脑疾病诊断的应用价值。方法选择2014年至2017年内蒙古自治区人民医院就诊新生儿1 340例,其中男性789例,女性551例,日龄3~7 d,早产儿403例,足月儿937例;胎龄29~40周。均于出生后3 d行超声检查,回顾性分析新生儿颅脑疾病的种类。随访治疗后患儿情况。结果 700例新生儿颅脑超声未见异常,640例新生儿颅脑存在疾病。新生儿颅内出血504例,发病率37.6%,明显高于其他疾病(脑室增宽56例,脑室周围白质损伤39例,脉络丛囊肿5例,缺血缺氧性脑病12例,额叶偏小24例)。403例早产儿中颅内出血359例,发病率89.1%;237例足月儿中颅内出血145例,发病率61.2%;组间比较,足月儿颅内出血的发生率低于早产儿,差异有统计学意义(P<0.05)。Ⅰ级颅内出血发生率>Ⅱ级>Ⅲ级>Ⅳ级;Ⅰ级和Ⅱ级颅内出血发生率明显高于Ⅲ级和Ⅳ级(P<0.05)。治疗后随访3~5个月,Ⅰ级和Ⅱ级颅内出血病灶基本吸收;Ⅲ级至9个月才完全吸收,智力发育正常,而Ⅳ级病灶仍未吸收,患儿智力发育迟缓。结论颅脑超声在新生儿颅内病变诊断中具有重要意义,尤其在颅内出血的诊断、随访及治疗指导中具有重要价值,颅脑超声以其无创、无辐射、便捷的优势,可作为新生儿颅脑病变的筛查工具。
Objective To investigate the value of cranial ultrasound in the diagnosis of neonatal cerebral disease. Methods From 2014 to 2017, a total of 1 340 cases aged 3-7 days neonate（gestational aged 29-40 weeks） were enrolled, which included 789 males and 551 females, 403 cases of premature infants and 937 of full-term infants. All of them were performed ultrasonography at 3 days after birth. The types of neonatal cerebral disease were analyzed and followed-up. Results The 700 neonatal cranial ultrasound results were normal but 640 cases showed neonatal cerebral disease. The 504 cases showed neonatal intracranial hemorrhage, the incidence rate was 37.6 %, which was significantly higher than that of other diseases（56 cases of ventricular widened, 39 of periventricular white matter injury, 5 of choroid plexus cyst, 12 of hypoxic-ischemic encephalopathy and 24 of frontal lobe）. In 403 premature infants, there were 359 cases with intracranial hemorrhage. The incidence rate was 89.1 %; In 237 cases of full-term infants, there were 145 cases with intracranial hemorrhage, the incidence rate was 61.2 %; Compared with incidence rate of intracranial hemorrhage, the full-term infants were lower than preterm in-fants, the difference was statistically significant（P〈0.05）. The incidence rate of intracranial hemorrhage was grade Ⅰ gradeⅡ grade Ⅲ grade Ⅳ; the incidence rate of intracranial hemorrhage of grade Ⅰ and Ⅱ were significantly higher than those of grade Ⅲ and Ⅳ（P〈0.05）. Follow-up 3 to 5 months after treatment, intracranial hemorrhage lesions of grade Ⅰ and Ⅱ were absorbed; grade Ⅲ lesions were completely absorbed after 9-month with normal mental development, but grade Ⅳ lesions were existed with mental retardation. Conclusion The ultrasound has important significance in the diagnosis of neonatal intracranial diseases, especially in the diagnosis, treatment and follow-up of intracranial hemorrhage for cerebral ultrasound guidance with non-invasive and convenient, which could be used as the screening tool for neonatal brain lesions.
出处
《生物医学工程与临床》
CAS
2018年第1期53-57,共5页
Biomedical Engineering and Clinical Medicine
关键词
超声检查
经颅脑
颅内出血
新生儿
ultrasonography
transcranial
intracranial hemorrhage
neonate
