【摘要】 目的探讨核磁共振成像(MRI)评估新生儿窒息后脑损伤及预后的应用价值。方法 120例足月新生儿窒息患儿,随机分为对照组和试验组,各60例,于患儿出生后3~10 d分别对对照组进行头颅CT检查,试验组进行头颅MRI检查,对比两组脑损伤检出率,并且于出生后6个月~2岁对患儿进行随访,同时在随访时分别对对照组复查CT及试验组复查MRI评估其预后,并进行相应干预,最终行神经心理发育检查。结果试验组脑损伤检出率(95.00%)高于对照组(81.67%),差异具有统计学意义(χ~2=5.175,P=0.023<0.05);对照组CT检查结果显示,60例患儿中有11例CT未见异常,13例低密度区侵及两侧的大脑半球,18例低密度白质区侵及脑叶>2叶,12例低密度白质区侵及脑叶≤2叶,出血性病变6例。试验组MRI结果显示,60例患儿中3例正常,22例轻度异常,25例中度异常,10例重度异常。对照组随访结果显示,对于神经心理发育评价,21例发育低下,34例发育偏低,5例发育正常;试验组随访结果显示,对于神经心理发育评价,8例发育低下,32例发育偏低,20例发育正常;随访结果中发育正常与发育偏低定为预后良好,发育低下定为预后不良。随访结果显示试验组预后效果优于对照组,差异具有统计学意义(χ~2=7.685,P=0.006<0.05)。结论 MRI对评估新生儿窒息后脑损伤及预后具有重要临床应用价值。更多还原

【Abstract】 Objective To investigate application value of magnetic resonance imaging(MRI) in evaluation of cerebral injury after neonatal asphyxia and prognosis. Methods A total of 120 full-term newborn with neonatal asphyxia were randomly divided into control group and experimental group, with 60 cases in each group. The control group received head CT examination in postnatal 3~10 d, and the experimental group received head MRI instead. Detection rates of cerebral injury were compared between two groups. Follow-up in postnatal 6 months~2 years provided CT and MRI examination respectively in the two groups, followed by related intervention, along with neuropsychology development examination. Results The experimental group had higher detection rate of cerebral injury(95.00%) than the control group(81.67%), and the difference had statistical significance(χ2=5.175, P=0.023<0.05). CT examination for the control group showed 11 cases among 60 cases with no CT abnormity, 13 cases with cerebral hemisphere-involved low density area, 18 cases with >2 lobe-involved low density alba area, 12 cases with ≤ 2 lobe-involved low density alba area, and 6 cases with hemorrhagic lessons. MRI for the experimental group showed 3 normal cases among 60 cases, 22 mild abnormal cases, 25 moderate abnormal cases, and 10 severe abnormal cases. Follow-up for neuropsychology development evaluation in the control group showed 21 cases with low development, 34 cases with flat development, and 5 cases with normal development. Follow-up for neuropsychology development evaluation in the experimental group showed 8 cases with low development, 32 cases with flat development, and 20 cases with normal development. Normal and flat development were taken as good prognosis, and low development as poor prognosis. Follow-up outcome showed better prognosis effect in the experimental group than the control group, and their difference had statistical significance(χ2=7.685, P=0.006<0.05). Conclusion MRI contains important clinical application value in evaluation of cerebral injury after neonatal asphyxia and prognosis.更多还原