摘要
目的调查与分析头颅超声在早产儿脑损伤中的大规模筛查效果。方法 2014年9月到2018年2月选择在本院分娩的早产儿220例,所有早产儿都给予头颅超声检查,记录影像学特征并判断脑损伤的筛查效果。结果在220例早产儿中,头颅超声检出脑损伤45例,检出率为20.45%,其中脑室内出血32例,缺氧缺血性改变10例,脑室周围白质软化3例。脑损伤组的性别、出生体质量、胎龄与分娩方式与非脑损伤组对比差异无统计学意义(P>0.05),脑损伤组的1 min Apgar评分、5 min Apgar评分显著低于非脑损伤组(P<0.05)。脑损伤组超声显示颅内异常回声增强,伴不同程度侧脑室增宽;非脑损伤组超声显示双侧脑室呈无回声反射,脑室周围未见异常回声。脑损伤组的大脑卷曲程度、髓鞘化程度、胶质细胞迁移带等特征评分显著低于非脑损伤组(P<0.05)。大脑中动脉血流参数显示脑损伤组的Vs和RI显著高于非脑损伤组,而Vd显著低于非脑损伤组(P<0.05);把MRI筛查作为金标准,头颅超声筛查早产儿脑损伤的敏感性与特异性为100.0%和98.9%。结论头颅超声在早产儿脑损伤中的大规模筛查中的应用具有很高的诊断效果,可为早产儿脑损伤的首选影像诊断方法。
Objective To investigate and analysis of large-scale screening effects of cranial ultrasound in brain damage in premature infants. Methods From September 2014 to February 2018, 220 cases of preterm infants who gave birth in our hospital were selected. All premature infants were given ultrasound examination of the head, recording imaging features and judging the screening effect of brain injury. Results In 220 premature infants, 45 premature infants of brain injury were detected by head ultrasound, the detection rate were 20.45%, included 32 cases of intraventricular hemorrhage, 10 cases of hypoxic ischemic change, and 3 cases of periventricular white matter softening. There were no significant difference in gender, birth weight, gestational age, delivery mode compared between the non-brain injury group and brain injury group(P>0.05). The 1 min Apgar score and 5 min Apgar score in the brain injury group were significantly lower than in the non-brain injury group(P<0.05). Ultrasound in the brain injury group showed an increase in intracranial abnormal echo, with different degrees of lateral ventricle widening. Ultrasound in the non-brain injury group showed no echogenic reflection in bilateral ventricles, and no abnormal echo around the ventricles. The scores of brain curl, myelination and glial migration were significantly lower in the brain injury group than in the non-brain injury group(P<0.05). The parameters of middle cerebral artery blood flow showed that the Vs and RI of the brain injury group were significantly higher than those of the non-brain injury group, while the Vd was significantly lower than that of the non-brain injury group(P<0.05). The MRI screening was used as the gold standard, and the cranial ultrasound was used to screen the premature delivery. The sensitivity and specificity of brain injury were 100.0% and 98.9%. Conclusion The application of cranial ultrasound in large-scale screening of brain injury in premature infants has a high diagnostic effect and can be the first choice for imaging diagnosis of brain damage in premature infants.
作者
耿铮子
管艳萍
GENG Zhengzi;GUAN Yanping(Ultrasonic Department, Linxia People's Hospital of Gansu, Linxia 731100, China)
出处
《国外医学（医学地理分册）》
CAS
2019年第1期69-71,79,共4页
Foreign Medical Sciences：Section of Medgeography
关键词
头颅超声
早产儿
脑损伤
诊断筛查
脑室内出血
cranial ultrasound
premature infant
brain injury
diagnostic screening
intraventricular hemorrhage
