早产儿脑损伤影像学及脑电图诊断的研究进展

发布时间：2018-04-29 00:05

本文选题：脑损伤 + 诊断　；参考：《临床儿科杂志》2017年07期

【摘要】：早产儿特别是28周的超未成熟儿,由于脑血管发育不成熟,脑血流自主调节能力较差,极易出现脑血流动力学紊乱,且早产儿神经元、少突胶质细胞及其前体对缺氧缺血异常敏感,耐受性低,易损性高,导致早产儿脑损伤及神经系统后遗症发生率较足月儿高。但临床上早产儿脑损伤往往缺乏明显的神经系统症状和体征,容易漏诊而错过治疗时机。头颅超声、MRI及脑电图均是早产儿脑损伤早期诊断的特殊检查手段。在早期颅内出血诊断上头颅超声优于后两者,但脑白质软化评估则MRI特别是DWI诊断价值最高,而脑电图可在各时期辅助诊断脑损伤患儿,三者各有优劣,临床上若能合理运用三者诊断早产儿脑损伤,则有助于及时发现疾病,尽早治疗,减少早产儿神经系统后遗症的发生,降低致残率,改善远期预后。
[Abstract]:Premature infants, especially the super immature infants of 28 weeks, are prone to cerebral hemodynamic disturbance due to the immature cerebral vascular development and poor ability of cerebral blood flow self-regulation, and the neurons of preterm infants. Oligodendrocytes and their precursors are highly sensitive to hypoxia and ischemia, with low tolerance and high vulnerability, resulting in a higher incidence of brain damage and neurological sequelae in premature infants than in full-term infants. But clinically premature infants often lack of obvious nervous system symptoms and signs, and miss the diagnosis easily and miss the time of treatment. MRI and EEG are special methods for early diagnosis of brain injury in premature infants. In the early diagnosis of intracranial hemorrhage, the upper skull ultrasound was superior to the latter two, but the value of MRI, especially DWI, was the highest in the evaluation of leukomalacia, and EEG could assist in the diagnosis of brain injury in children with brain injury at different stages, and each of them had its own advantages and disadvantages. If we can diagnose the brain injury of premature infants by using the three methods reasonably, it will be helpful to find diseases in time, treat them as early as possible, reduce the occurrence of neurological sequelae of preterm infants, reduce the rate of disability and improve the long-term prognosis.
【作者单位】：广州医科大学附属广东省妇儿医院;
【分类号】：R742

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