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时间:2019-10-18
《床旁颅脑超声在早产儿脑损伤诊断中的应用》由会员上传分享,免费在线阅读,更多相关内容在工程资料-天天文库。
1、床旁颅脑超声在早产儿脑损伤诊断中的应用高昂朱梅英苏州市立医院新生儿科摘要:目的探讨床旁颅脑超声在早产儿脑损伤诊断屮的应用价值。方法以2015年1月至2016年6月苏州市立医院NICU收治胎龄W33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MR1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)。其中颅内岀血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,
2、其余52例报告与B超相符。颅脑B超界常检出率为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)。颅内岀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而具有优越性,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;作者简介:高昂(1978-),女,副主任医师。研究方向:新生
3、儿颅脑疾病及颅脑超声诊断E-mail:ang7859@sina.com收稿日期:2017-01-05基金:江苏省妇幼保健科研项目(F201410)ApplicationofbedsidecranialultrasoundinthediagnosisofbraininjuryinprematureinfantsGAOAngZHUMeiyingDepartmentofNeonatology,SuzhouMunicipalHospital;Abstract:ObjectiveToinvestigatetheapplicationvalueofbedsideeranialultr
4、asoundinthediagnosisofprematurebraininjury.MethodsTotally529preterminfantswithgestationeilageW33weeksinNICUofSuzhouMunicipalHospitalwereincludedfromJanuary2015toJune2016.Allofthemwereexaminedbybedsidecranialultrasound,andsomeofthemwerealsoexaminedbyeranialMRIorCTascontrols.ResuItsTherewer
5、e302casesofbraininjury,including272casesofintracranialhemorrhage,60casesofcerebralwhitematterinjury(38casesofthemwerecombincdwithdifferentdegreeofintracranialhemorrhage),and14casesofotherbraininjurydiseases.Totally56casesofbraininjuryweredetectedbyMRIorCTin183preterminfants;3casesofsubara
6、chnoidhemorrhageand1caseofsubduralhemorrhagewerenotdetectedbyeranieilultrasound,andtheother52caseswereinaccordanccwitheranialultrasoundreport.ThedetectionrateofcranialMR1andCTwas30.60%(56/183).Atotalof298casesofbraininjuryweredetectedbycranialultrasound.Thedetectionrateofbedsideeranialult
7、rasoundexaminationwas56.33%(298/529),whichwassignifiedntlyhigherthanthatofcranialMRTandCT,thediffercnccbeingstatisticallysignificant(P〈0.05)•Theincidcnccrateofcerebralwhitematterinjuryinpreterminfantswithintracranialhemorrhagewas13.97%(38/272),andthatinpreterminfant
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