王倩楠 吴文海 王业珠

【摘要】目的：探究床旁颅脑超声在新生儿颅内出血诊断中的应用价值。方法：选择新生儿颅内出血患儿作为研究对象，病例数38例，时间2019年1月至2021年1月，对患儿进行CT检查与床旁颅脑超声检查，比较颅内出血检出率，分析床旁颅脑超声影像学特征。结果：在新生儿颅内出血诊断中，使用CT与床旁颅脑超声进行检查，检出率分别为92.11%和94.73%，差异不显著（P<0.05）。新生儿颅内出血的床旁颅脑超声影像学特征为，在脑室膜下出血颅脑超声结果中可见背侧丘脑尾状核沟处异常回声，少量出血为局部增强回声，出血量多时见无回声区。脑室内出血可见不断增强回声，表现不规则团块。存在脑实质出血时，可在脑室周围实质内见到大小不一、形态不同的高回声，有清晰边缘。与正常新生儿丘脑尾状核应该有的均匀回声差异较大。结论：在新生儿颅内出血诊断中应用床旁颅脑超声可得到比较高的检出率，与CT比较检出率相当，且与健康新生儿颅脑超声图像特征有较大差异，做准确鉴别诊断，临床应用价值高。

【关键词】新生儿颅内出血;床旁颅脑超声;CT检查;检出率;超声图像特征

【中图分类号】R445.1;R743.34 【文献标识码】A 【DOI】10.12332/j.issn.2095-6525.2021.15.017

【Abstract】Objective：To investigate the application value of bedside intracranial ultrasound in the diagnosis of neonatal intracranial hemorrhage. Methods： With neonatal intracranial hemorrhage with 38 cases from January 2019 to January 2021， CT and bedside craniocerebral ultrasound were performed， the detection rate of intracranial hemorrhage was compared and the characteristics of bedside craniocerebral ultrasound were analyzed. Results： In the diagnosis of neonatal intracranial hemorrhage， CT and bedside craniocerebral ultrasound were detected at 92.11% and 94.73%， respectively （P <0.05）. Parbedside intracranial ultrasound imaging of neonatal intracranial hemorrhage The characteristics is that the abnormal echo of the dorsal thalamus can be seen in the craniocerebral ultrasound results of subventricular hemorrhage， a small amount of bleeding is local enhanced echo， and no echo area. Inventricular hemorrhage shows enhanced echo and irregular clumps. In the presence of cerebral parenchymal hemorrhage， high echoes of different sizes and different morphology can be seen in the surrounding ventricular parenchymal， with clear edges. The uniform echo should differ greatly from the normal neonatal thalamus. Conclusion： The detection of bedside craniocerebral ultrasound in the diagnosis of neonatal intracranial hemorrhage is comparable to CT， and the craniocerebral ultrasound image of healthy newborns Features are quite different， and we do accurate differential diagnosis， with high clinical application value.

【Key words】Neonatal intracranial hemorrhage; bedside intracranial ultrasound; CT examination; detection rate; ultrasound image characteristics

“新生兒颅内出血”是新生儿期比较常见的一种严重疾病，主要由早产、凝血功能异常、产伤、血管畸形以及缺氧缺血引起，根据出血部位不同可以分为蛛网膜下腔出血、脑实质出血、脑室膜下及脑室内出血、硬膜下出血以及硬膜外出血等[1]。足月儿颅内出血类型主要是硬膜下出血和蛛网膜下腔出血，早产儿颅内出血以脑室膜下、脑室内出血为主[2]。……