摘要
目的对早产儿生后12-24h内经颅超声多普勒（TCD）监测，探讨其在早产儿脑室内出血（IVH）早期预测和神经发育预后评估中的价值。方法对2003年5月至2005年2月间在我院NICU住院的93例早产儿生后12-24h内应用TCD监测早产儿脑血流动力学参数，并将监测结果与颅脑超声检查IVH发生与否及12月时的神经发育预后进行相关性分析，分析其在早产儿IVH早期诊断和神经发育预后预测中的价值。结果93例早产儿中，62例发生IVH，其中轻度28例，重度4例。有IVH组早产儿生后早期收缩期血流峰速（Vs）、平均血流速率（Vm）及舒张期流速（Vd）分别为（单位：cm／s）40．3±8．3、22．9±5．7和10．3±5．5，均明显高于无IVH组（分别为32．9±5．1、16．6±3．9和4．0±4．8）（P〈0．001），而搏动指数（PI）、阻力指数（RI）分别为1．49±0．48和0．75±0．14，均明显低于无IVH组（1．96±0．52和0．89±0．15）（P〈0．001）。对57例作神经发育预后分析，神经发育不良和正常者各参数均无显著性差异。结论早产儿在生后早期应用TCD监测脑血流动力学参数．能早期预测早产儿IVH的发生与否，对预测神经发育预后可能无明显价值。
Purpose To monitor preterm infants with transeranial Doppler （TCD） 12-24 hours after birth and assess TCD in early diagnosis value of intraventricular hemorrhage （IVH） and its prognosis in the preterm infants. Methods Ninety-three preterm infants were monitored by TCD 12-24 hours after birth from May 2003 to February 2005 in our NICU to monitor the cerebral hemodynamic. The results of TCD were compared with those of cranial ultrasonography and follow-up at 12 months. Results Among 93 preterm infants, 62 preterm infants developed IVH（28 mild cases and 4 severe cases）. The systolic velocity （Vs）, mean velocity （Vm） and diastolic velocity （Vd） of the preterm infants with IVH [（40.3 ± 8.3）, （22.9 ± 5.7） and （10.3 ± 5.5） cm/s respectively.1 early after birth were obviously higher than those without IVH [（32.9 ± 5.1）, （16.6 ± 3.9） and （4.0 ± 4.8） cm/s respectively]（P〈0. 001）. Pulsatility index （PI） and resistance index （RI） of the preterm infants with IVH[（1.49 ± 0.48） and （0.75 ± 0.14）-1 were obviously lower than those without IVH [（1.96 ± 0.52） and （0.89 ± 0. 15）.1 （P〈0. 001）. Among 52 preterm infants with neurological outcome analysis, there was no significant difference between the parameters of preterm infants with abnormal outcome and those with normal outcome. Conclusions Early TCD monitoring of cerebral hemodynamic in preterm infants could predict the occurrence of IVH but couldn＇t predict its neurological outcome.
出处
《复旦学报（医学版）》
CAS
CSCD
北大核心
2006年第3期340-342,共3页
Fudan University Journal of Medical Sciences
基金
教育部211工程Ⅱ期重点学科资助
关键词
经颅超声多普勒
脑室内出血
早产儿
transcranial Doppler
intraventriclar hemorrhage
preterm infants
