ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2017, Vol. 9 ›› Issue (5): 394-396.doi: 10.3969/j.issn.1674-3865.2017.05.009

• 临床研究 • 上一篇    下一篇

床旁颅脑超声在早产儿脑损伤诊断中的应用

高昂，朱梅英   

  1. 215002 江苏 苏州，苏州市立医院新生儿科
  • 出版日期:2017-10-25 发布日期:2017-12-18
  • 通讯作者: 高昂，E-mail:ang7859@sina.com
  • 作者简介:高昂（1978-），女，副主任医师。研究方向：新生儿颅脑疾病及颅脑超声诊断
  • 基金资助:
    江苏省妇幼保健科研项目（F201410）|苏州市科技发展计划项目（SYSD2013109）

Application of bedside cranial ultrasound in the diagnosis of brain injury in premature infants

GAO Ang, ZHU Meiying   

  1. Department of Neonatology, Suzhou Municipal Hospital, Suzhou 215002,China
  • Online:2017-10-25 Published:2017-12-18

PDF (PC)

125

摘要：
目的
探讨床旁颅脑超声在早产儿脑损伤诊断中的应用价值。
方法
以2015年1月至2016年6月苏州市立医院NICU收治胎龄≤33周的早产儿529例为研究对象，全部行床旁颅脑超声检查，部分病例辅以头颅MRI或CT对照。
结果
529例早产儿中，脑损伤者302例（其中B超检出298例，B超未检出4例，后经MRI或CT检出）。其中颅内出血272例，早产儿脑白质损伤60例（其中38例合并不同程度颅内出血），其他颅脑疾病14例。183例患儿经MRI或CT检出脑损伤56例，除3例蛛网膜下腔出血及1例硬膜下出血B超未探及，其余52例报告与B超相符。颅脑B超异常检出率为56.33%（298/529），显著高于头颅MRI及CT异常检出率30.60%（56/183），差异有统计学意义（P<0.05）。颅内出血患儿脑白质损伤发生率为13.97%（38/272），显著高于非颅内出血患儿脑白质损伤发生率8.56%（22/257），差异有统计学意义（P<0.05）。
结论
早产儿脑损伤是动态变化的，床旁颅脑超声在早期筛查及动态监测方面具有优越性，可与头颅MRI及CT结合应用提高诊断准确性。

关键词: 脑损伤, 颅脑超声, 颅内出血, 脑白质损伤, 婴儿, 早产

Abstract:
Objective
To investigate the application value of bedside cranial ultrasound in the diagnosis of premature brain injury.
Methods
Totally 529 preterm infants with gestational age ≤33 weeks in NICU of Suzhou Municipal Hospital were included from January 2015 to June 2016. All of them were examined by bedside cranial ultrasound, and some of them were also examined by cranial MRI or CT as controls.
Results
There were 302 cases of brain injury,including 272 cases of intracranial hemorrhage,60 cases of cerebral white matter injury(38 cases of them were combined with different degree of intracranial hemorrhage),and 14 cases of other brain injury diseases. Totally 56 cases of brain injury were detected by MRI or CT in 183 preterm infants|3 cases of subarachnoid hemorrhage and 1 case of subdural hemorrhage were not detected by cranial ultrasound, and the other 52 cases were in accordance with cranial ultrasound report. The detection rate of cranial MRI and CT was 30.60%(56/183). A total of 298 cases of brain injury were detected by cranial ultrasound. The detection rate of bedside cranial ultrasound examination was 56.33%(298/529),which was significantly higher than that of cranial MRI and CT, the difference being statistically significant(P<0.05).The incidence rate of cerebral white matter injury in preterm infants with intracranial hemorrhage was 13.97%(38/272), and that in preterm infants without intracranial hemorrhage was 8.56%(22/257),the difference being statistically significant(P<0.05).
Conclusion
Brain injury in premature infants is dynamic. The bedside cranial ultrasound has advantages in early screening and dynamic monitoring. Diagnostic accuracy may be improved if it is combined with MRI or CT.

Key words: Brain injury, Cranial ultrasound, Intracranial hemorrhage, Cerebral white matter injury, Infant, premature