高小午

[摘要] 目的 探究大脑中动脉血流动力学检查对新生儿贫血的预测价值。 方法 便利选择2018年1—12月于该院出生的121例新生儿为研究对象，对其实施大脑中动脉血流速度检测，以80cm/s为分界线将121例新生儿分为正常组（68例）和异常组（53例），对两组新生儿进行血常规检测，对比两组新生儿贫血发生率、平均流速（Vm），而后将异常组新生儿按照大脑中动脉血流速度分为80～90 cm/s、91～100 cm/s、100 cm/s以上3组，对比3组新生儿贫血发生率，并就大脑中动脉血流速度与新生儿血红蛋白相关性进行分析。 结果 ①正常组新生儿贫血发生率为8.82%（6/68），异常组新生儿贫血发生率为67.92%（36/53），正常组新生儿Vm明显低于异常组，两组对比差异有统计学意义（χ2=45.907;t=41.694，P<0.05）;②分析发现，血流速度为80～90 cm/s新生儿贫血发生率为35.00%（7/20），91～100 cm/s新生儿贫血发生率为81.25%（13/16），100cm/s以上新生儿贫血发生率为94.12%（16/17），组间对比差异有统计学意义（P<0.05）;③相关性分析显示，新生儿大脑中动脉血流速度与其血红蛋白呈负相关性（r=-0.635，P<0.05）。 结论 大脑中动脉血流速度的检测对新生儿贫血具有一定预测价值，有利于提前对新生儿实施干预，改善其预后。

[关键词] 大脑中动脉;新生儿贫血;预测价值

[中图分类号] R714          [文獻标识码] A          [文章编号] 1674-0742（2020）04（a）-0181-03

[Abstract] Objective To investigate the predictive value of middle cerebral artery hemodynamics examination for neonatal anemia. Methods A total of Convenient selection 121 neonates born in the hospital from January 2018 to December 2018 were enrolled. The blood flow velocity of the middle cerebral artery was measured. The 121 neonates were divided into 80 cm/s. In the normal group （68 cases） and the abnormal group （53 cases）， blood tests were performed on the newborns of the two groups. The incidence of anemia and mean flow rate （Vm） were compared between the two groups. The flow velocity was divided into three groups of 80～90 cm/s， 91～100 cm/s， and 100 cm/s. The incidence of anemia in the three groups was compared， and the correlation between the blood flow velocity of the middle cerebral artery and neonatal hemoglobin was analyzed. Results ①The incidence of anemia in the normal group was 8.82% （6/68）， the incidence of anemia in the abnormal group was 67.92% （36/53）， and the Vm in the normal group was significantly lower than that in the abnormal group. The difference was statistically significant（χ2=45.907;t=41.694， P<0.05）. ②The analysis found that the incidence of anemia was 35.00%（7/20） in neonatal blood flow rate of 80-90 cm/s， and anemia occurred in 91-100 cm/s neonates. The rate was 81.25%（13/16）， and the incidence of anemia in neonates above 100cm/s was 94.12% （16/17）. The difference between the groups was statistically significant （P<0.05）. （3） Correlation analysis showed that Neonatal middle cerebral artery blood flow velocity was negatively correlated with hemoglobin（r=-0.635， P<0.05）. Conclusion The detection of blood flow velocity in middle cerebral artery has certain predictive value for neonatal anemia， which is beneficial to the intervention of newborns and improve their prognosis.

[Key words] Middle cerebral artery; Neonatal anemia; Predictive value

新生儿贫血是近些年产科及儿科较常见的疾患之一，该病特征为出生后2周静脉血红蛋白低于130 g/L，新生儿贫血原因较为复杂，诸如产前出血、产时失血等均可诱发新生儿贫血的出现，罹患该病的新生儿正常的生长发育会受到影响，尤其是部分早产儿或低体重儿，贫血甚至可能诱发心力衰竭及其他并发症，严重威胁新生儿生命健康。早期新生儿贫血临床症状往往并不明显，难以引起家长或医护人员重视，但晚期新生儿贫血进展较快，患儿可出现气促、心率增快、低血压等症，部分新生儿还可出现肝脾肿大、充血性心力衰竭，干预难度较大[1-2]。因而及早对贫血做出诊断对提高新生儿预后、降低新生儿病死率具有重要意义。……