高压氧对围生期缺氧缺血事件新生儿脑血流的影响

摘要

Objective To observe the changes of cerebrovascular hemodynamics of newborn with perinatal period hypoxia ischemia which might lead to hypoxic-ischemic encephalopathy(HIE),and study the effects of hyperbaric oxygen (HBO) therapy effect.Methods Parameters of blood flow of middle cerebral artery (MCA) in anterior 60 neonates with perinatal hypoxia ischemia was measured by Color Doppler Ultrasonography,the neonates were enrolled from Dec.2008 to Jun.2010.60 cases were randomly divided into HBO group (n =30) and control group (n =30).Results ①Change of systolic peak velocity (Vs) and end-diastolic velocity (Vd):in all hemodynamic parameters,there were no obvious changes found,after the 1st and 2nd day' s therapy (P＞0.05).But Vs was significantly lower than that after 1st and 2nd day' s therapy (P＜0.05),Vd was significantly lower (P＜0.01) after the 3rd day' s treatment,and after the 4th day' s therapy,both Vs and Vd were highly significantly lower than those after the 1 st,the 2nd and the 3rd day's therapy(P＜0.01).②Change of resistence index (RI):after the 3rd and 4th day's treatment,RI was significantly higher (P＜0.01).Conclusions The anaphase of HBO treatment can lead to a decrease in cerebral blood flow and induces vasoconstriction in neonate with perinatal hypoxia ischemia,which might be in favor of the treatment for cerebral injury of HIE neonates.%目的 通过检测围生期缺氧缺血事件新生儿高压氧(HBO)治疗前后的脑血流,了解高压氧治疗对有围生期缺氧缺血事件新生儿脑灌注的影响.方法 于2008年12月-2010年12月在我院住院的有围生期缺氧缺血病史的新生儿中,随机选取30例,用彩色超声多普勒检测每次HBO治疗前后通过大脑中动脉(MCA)脑血流情况,连续检测其大脑前动脉的收缩期峰值(Vs)、舒张末期速度(Vd)、阻力指数(RI).所得数据采用SPSS 13.0统计软件进行统计分析.结果 脑血流速度的改变:HBO治疗的第1、2天,治疗前后脑血流速度无明显改变;治疗第3天,Vs、Vd较前降低,其中Vs差异有显著性(P＜0.05),Vd差异有极显著性(P＜0.01);治疗第4天,Vs、Vd较前降低,Vs、Vd差异有极显著性(P＜0.01).血管阻力指数的变化:HBO治疗的第1、2天,无明显改变;治疗第3天,RI较前升高,RI差异有极显著性(P＜0.01);治疗第4天,RI较前升高,RI差异有极显著性(P＜0.01).结论 对围生期缺氧缺血事件新生儿进行HBO治疗,初期脑灌注影响不明显,治疗后期产生明显影响,可使脑血管收缩并致血流速度减慢,从而影响脑灌注.