ISSN 1004-4140
CN 11-3017/P

高压氧治疗新生儿缺血缺氧性脑病CT动态变化与临床对比

The Study of CT Dynamic Changes and Clinical Comparison in Neonatal Hypoxic-ischemic Encephalopathy Treated by Hyperbaric Oxygen

  • 摘要: 目的:探讨新生儿缺氧缺血性脑病(HIE)行高压氧(HBO)治疗前、中、后脑部CT所表现的动态变化与临床效果对比。方法:回顾性分析85例HIE新生儿的临床和CT资料,按照治疗前脑部CT表现分为轻、中、重三型,行HBO及常规辅助治疗于1、2、3个疗程后分别行脑部CT复查,对三型HIECT转归情况与临床效果进行对比分析。结果:85例患儿行HBO治疗前CT检查,其中轻度HIE20例,中度HIE42例,重度HIE合并脑出血23例;HBO及常规辅助治疗1个疗程后复查CT,轻度HIE中有9例转阴,临床症状恢复正常,还有11例轻度的和中度的、重度的HIE与治疗前CT检查结果相比有好转,临床症状减轻,CT总转归率为11.12%(9/85);HBO及常规辅助治疗2个疗程后复查CT,轻度的20例HIE全部转阴,中度的HIE中有30例转阴,CT总转归率58.82%(50/85),其中中度的12例及重度的23例与治疗前CT检查结果明显好转,临床症状亦明显减轻;HBO及常规辅助治疗3个疗程后复查CT,中度的HIE全部转阴,重度的HIE中有12例转阴,CT总转归率87.06%(74/85),其中重度的HIE合并脑内出血的11例患儿,CT示出血全部吸收,留下软化灶,临床症状明显好转。结论:应用CT显示新生儿脑部动态变化对HBO治疗HIE有重要指导价值。

     

    Abstract: Objective: For neonatal hypoxic ischemic encephalopathy(HIE) of hyperbaric oxygen(HBO) therapy,brain CT showed dynamic changes and clinical effect comparison.Methods: A retrospective analysis of 85 cases of HIE neonatal clinical data and CT before treatment,according to CT findings of the brain is divided into light,medium,heavy type 3,HBO and conventional adjuvant therapy in 1,2,3 respectively after a course of brain CT review,on 3 type CT prognosis and clinical comparison analysis.Results: 85 cases of children with HBO before treatment CT examination,in which mild HIE in 20 cases,moderate HIE in 42 cases,severe HIE complicated with cerebral hemorrhage of 23 cases;HBO and conventional adjuvant treatment after 1 courses of treatment review of CT in 9 cases,mild HIE negative,symptoms returned to normal,and 11 cases of mild and moderate,severe HIE before treatment with CT examination results slightly better,alleviation of clinical symptoms,CT total turnover rate was 11.12%(9/85);HBO and conventional adjuvant treatment after 2 courses of treatment review of CT,mild in 20 patients with HIE all negative,moderate HIE in 30 patients were negative,CT turnover rate of 58.82%(50/85),of which 12 cases of moderate and severe in 23 patients before treatment with CT examination results improved significantly,the clinical symptoms were also significantly reduced;HBO and conventional adjuvant treatment after 3 courses of treatment review of CT,mild and moderate HIE all negative,severe HIE in 12 patients were negative,CT turnover rate of 87.06%(74/85),in which severe HIE with intracerebral hemorrhage in 11 cases,CT shows hemorrhage absorbed,leaving encephalomalacia,clinical symptoms improved markedly.Conclusion: Application of CT display neonatal brain dynamic change on HBO treatment HIE have important guiding value.

     

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