论文部分内容阅读
目的研究新生儿红细胞增多症合并脑损伤的临床、影像学特征及其转归。方法分析2003年1月至2005年10月在我科住院的116例红细胞增多症患儿的临床特征,用颅脑超声、CT及MRI动态观察颅脑影像变化和脑血流变化,用近红外光谱分析测定脑氧合状态,并对22例中、重度病例进行3～12个月的随访。结果116例新生儿红细胞患儿中53例(45.7%)存在脑损伤,轻度31例、中度14例、重度8例。影像改变以不同范围、不同程度的缺血性损伤为主。脑损伤严重程度与红细胞增多症的持续时间、脑组织氧饱和度和脑血流异常有密切相关,经卡方检验和方差分析,显示差异有显著统计学意义(P<0.01)。而与治疗前的Hb和HCT升高程度关系不密切。随访发现中度病例(5/12)、重度病例(7/8)存在不同程度的神经系统发育异常。结论红细胞增多症容易造成脑缺血性损伤,部分病例能够影响到神经系统远期预后,以颅脑超声为主的影像检查为预后判断提供有用的方法。
Objective To study the clinical features and prognosis of neonatal polycythemia complicated with brain injury. Methods The clinical features of 116 children with polycythemia who were hospitalized in our department from January 2003 to October 2005 were analyzed. The changes of brain images and cerebral blood flow were observed with CT, Spectral analysis was used to determine the state of cerebral oxygenation, and 22 cases of moderate to severe cases were followed up for 3 to 12 months. Results Of 116 cases of neonatal erythrocytes, 53 cases (45.7%) had brain injury, 31 were mild, 14 were moderate, and 8 were severe. Image changes in different regions, varying degrees of ischemic injury-based. The severity of brain injury was closely related to the duration of polycythemia, oxygen saturation in brain tissue and abnormal cerebral blood flow. The chi-square test and variance analysis showed that the difference was statistically significant (P <0.01). But not with the level of Hb and HCT before treatment. Follow-up found moderate cases (5/12), severe cases (7/8) there are varying degrees of nervous system dysplasia. Conclusions Polycythemia is likely to cause cerebral ischemic injury. In some cases, the long-term prognosis of the nervous system can be affected. Imaging based on craniocerebral ultrasound provides a useful method for prognostic judgment.