摘要
目的研究新生儿缺氧缺血性脑病(HIE)的临床特点及磁共振成像(MRI)早期诊断价值。方法回顾性分析本院2016年8月至2019年12月收治的120例缺氧缺血性脑病患儿的临床资料,以此作为研究组,另选择同期在本院分娩的健康足月新生儿100例作为对照组,比较两组患者临床特点,分析HIE发生的高危因素,并对HIE患儿的MRI诊断特点进行研究,分析其早期诊断价值。结果两组患儿在出生体重、胎膜早破、宫内窘迫以及Apgar评分方面比较有统计学意义(P<0.05),在性别、分娩方式、前置胎盘、脐带绕颈方面比较无统计学意义(P>0.05);低体重、宫内窘迫、Apgar评分≤4分是导致新生儿发生HIE的独立危险因素(P<0.05);研究组患儿0~24h、24~72h内的收缩期峰值血流速度(Vs)、舒张末期血流速度(Vd)均显著低于对照组,阻力指数(RI)显著高于对照组,差异有统计学意义(P<0.05);双侧丘脑-基底节区存在对称性、不均匀的T_(1)WI高信号,多见于中、重度HIE患儿,且重度患儿脑内静脉扩张、颅内出血发生率显著高于轻中度患儿,差异有统计学意义(P<0.05);其余常规MRI表现三组患儿比较无统计学意义(P>0.05)。结论低体重、宫内窘迫、Apgar评分≤4分是HIE发生的高危因素,临床应多加关注,同时结合MRI诊断早期发现HIE及其病变部位,为HIE的预防和诊治提供指导。
Objective To study the clinical characteristics of neonatal hypoxic-ischemic encephalopathy(HIE)and the early diagnostic value of magnetic resonance imaging(MRI).Methods The clinical data of 120 neonates with HIE(study group)who were admitted and treated in the hospital between August 2016 and December 2019 were retrospectively analyzed.Meanwhile,100 healthy full-term neonates were selected as the control group.Clinical characteristics of the two groups were compared,and high-risk factors of HIE were analyzed.MRI findings of neonates with HIE were studied,and its early diagnostic value was analyzed.Results There were statistically significant differences between the two groups in terms of birth weight,premature rupture of membranes,intrauterine distress and Apgar score(P<0.05),but there was no statistically significant difference in gender,mode of delivery,placenta previa or umbilical cord around neck(P>0.05).Low birth weight,intrauterine distress and Apgar score≤4 points were independent risk factors for neonatal HIE(P<0.05).The peak systolic blood flow velocity(Vs)and end-diastolic blood flow velocity(Vd)of the study group were significantly lower than those of the control group,and the resistance index(RI)was significantly higher than that of the control group in 0 to 24h and 24 to 72h after birth(P<0.05).MRI showed symmetrical and uneven T_(1)WI high signals in bilateral thalamus-basal ganglia region,which was more common in children with moderate to severe HIE.The incidence of cerebral venous dilation and intracranial hemorrhage in severe neonates was significantly higher than that in mild to moderate ones(P<0.05).Other conventional MRI findings showed no statistically significant differences(P>0.05).Conclusion Low birth weight,intrauterine distress and Apgar score≤4 points are high-risk factors for HIE,which needs attention in clinical practice.Combined use of MRI can help early detection of HIE and the lesion location,thereby providing guidance for the prevention and treatment of HIE.
作者
张伟艳
陆凡
徐婷
周涵
宋磊
ZHANG Wei-yan;LU Fan;XU Ting;ZHOU Han;SONG Lei(Department of Pediatrics,the Second Affiliated Hospital of Nantong University(Nantong First People's Hospital),Nantong 226001,Jiangsu Province,China)
出处
《中国CT和MRI杂志》
2022年第3期8-10,共3页
Chinese Journal of CT and MRI
基金
南通市科技局支撑项目(MA2019001)。
关键词
新生儿
缺氧缺血性脑病
临床特点
磁共振成像
Neonate
Hypoxic-Ischemic Encephalopathy
Clinical Characteristics
Magnetic Resonance Imaging
