颅内出血早产儿脑血流变化研究

摘要

目的：：观察早产儿脑室周围-脑室内出血(PIVH)的超声表现,评价颅脑超声早期诊断 PIVH 的价值。方法：将10O例早产儿根据头颅彩超检查结果分为实验组77例和对照组23例,两组采用相同常规药物治疗,并根据出血严重程度将实验组分为轻度组65例和重度组12例,全部实验对象均在生后第3天、第10天进行头颅彩超检查收缩期血流速度与舒张末期血流速度的比值( S/D值)、阻力指数( RI)。结果：早产儿胎龄愈小,脑室内出血发生程度愈高；出生体重愈小,脑室内出血发生率、发生程度愈高；生后第3天颅内出血实验组头颅彩超S/D值、RI水平明显高于对照组( P<0.01),其中,重度组头颅彩超S/D值、RI水平高于轻度组(P<0.01)；第10天,轻度组患儿头颅彩超S/D值、RI水平已恢复至对照组水平(P>0.05),颅内出血重度组患儿头颅彩超S/D值、RI水平仍高于颅内出血轻度组及对照组( P<0.01)；颅内出血轻度及重度组患儿头颅彩超S/D值、RI水平生后第10天与第3天相比均明显降低(P<0.05)。结论：早产儿胎龄越小、出生体重越低,PIVH 发生率越高。对早产儿进行常规颅脑超声检查能早期诊断 PIVH,以早期指导临床干预治疗。%Objective:To observe the ultrasonographic features of the periventricular-intraventricular hemorrhage ( PIVH) in prema-ture infants and evaluate the value of early diagnosis of PIVH. Methods:100 premature infants were divided into the experimental group ( n=77) and the control group (n=23) according to cranial ultrasound examination results. The premature infants in both groups were given the same routine drug treatment. The premature infants in the experimental group were further divided into the severe group (n=12) and the mild group (n=65) according to the severity of bleeding. The ratio of the peaK systolic blood flow velocity and diastolic velocity (S/D) and the resistance index (RI) were measured with the cranium chromatic ultrasound on the 3rd and 10th day after premature infants were born. Results:The smaller the gestational age was,the higher the incidence of intraventricular hemorrhage was;the lighter the birth weight was,the higher the incidence and degree of intraventricular hemorrhage was;the S/D value and RI level was significantly higher in the experimental group than the control group on the 3rd day after born (P<0. 01),wherein,S/D value and RI level was higher in the se-vere group than the mild group (P<0. 01);S/D value and RI level in the mild group has been restored to the level of the control group on the 10th day after born (P>0. 05);S/D value and RI level was higher in the severe group than the mild group and the control group (P<0. 01);S/D value and RI level significantly decreased on the 10th day after born compared with that on the 3rd day after born in the mild and severe groups (P<0. 05). Conclusion:The smaller and the lighter the gestational age and the birth weight is,the higher the inci-dence of PIVH is. The routine cranial ultrasound examination can maKe an early diagnosis of PIVH in preterm infants so as to conduct timely clinical intervention.