摘要
目的:探讨早产儿围产期因素与大脑中动脉血流参数及脑损伤的关系。方法:床旁检测260例早产儿头颅,前囟窗检测脑组织,颞窗检测脑血流,将大脑中动脉血流参数与脑损伤以及胎龄、出生体重、围产期缺氧等因素进行关系对比研究。结果:本组260例早产儿中138例发生了PIVH,发生率为53.1%。其中Ⅲ级以上重度PIVH 25例,重度PIVH发生率9.6%,占PIVH总数的18.1%。PVL39例,发生率15%。PVL合并IVHⅠ级5例,Ⅱ级9例,Ⅲ级3例。轻度脑损伤113例,重度脑损伤61例。脑损伤发生率66.9%。不同胎龄、体重早产儿MCA流速Vs、Vd差异有统计学意义(P<0.05)。提示胎龄越大、出生体重越大,Vs、Vd流速越快。而不同分娩方式及围产期缺氧情况之间MCA流速差异无统计学意义(P<0.05)。早产儿第1、3、7天MCA流速差异有统计学意义(P<0.05)。随着日龄的增大,MCA流速逐渐增大,不同程度脑损伤组MCA流速差异有统计学意义(P<0.05)。脑损伤越重,其Vs、Vd及Vm流速越大;然而,脑损伤越重,RI、PI越低。结论:血流动力学的改变可作为预测早产儿脑损伤的发生与否及判断轻重程度的敏感指标。
Objective To study the relationship between the factor of peripartum,hemodynamic of MCA and brain injuries in preterm infants.Method 260 preterm infants were examined with bedside cranium color ultrasound.The relationship between blood flow parameters of MCA and brain injuries,gestational age,birth weight,Apgar scores were studied.Results There were 138 cases with PIVH,the morbidity was 53.1%.The morbidity of the serious PIVH was 9.6%.There were 39 cases with PVL,the morbidity was 15%.There were 113 cases with the light brain injuries and 61 cases with the serious brain injuries,the morbidity of brain injuries was 66.9%.The Vs,Vd of MCA was different between the preterm infants of different gestational age and birth weight（P0.05）.The flow rate of MCA was different in the first week（P0.05）.Conclusion The hemodynamics can prepest the brain injuries,and can judgement the degree of the brain injuries.
出处
《吉林医学》
CAS
2012年第31期6756-6758,共3页
Jilin Medical Journal
关键词
早产儿
血流动力学
围产期因素
脑损伤
Preterm infants
Hemodynamics
Factor of peripartum
Brain injuries
