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中华实验和临床感染病杂志(电子版) ›› 2016, Vol. 10 ›› Issue (05) : 579 -582. doi: 10.3877/cma.j.issn.1674-1358.2016.05.014

临床论著

69例新生儿中枢神经系统感染的颅脑超声结果分析
杜成1,()   
  1. 1. 518045 深圳市,深圳市福田区妇幼保健院医学影像科
  • 收稿日期:2015-07-11 出版日期:2016-10-15
  • 通信作者: 杜成

Analysis of brain ultrasound result of 69 cases with neonatal central nervous system infection

Cheng Du1,()   

  1. 1. Department of Radiology, Women and Children Health Care Hospital, Shenzhen 518045, China
  • Received:2015-07-11 Published:2016-10-15
  • Corresponding author: Cheng Du
引用本文:

杜成. 69例新生儿中枢神经系统感染的颅脑超声结果分析[J/OL]. 中华实验和临床感染病杂志(电子版), 2016, 10(05): 579-582.

Cheng Du. Analysis of brain ultrasound result of 69 cases with neonatal central nervous system infection[J/OL]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2016, 10(05): 579-582.

目的

观察新生儿中枢神经系统感染颅脑超声声像图改变的特点。

方法

选取69例中枢神经系统感染新生儿为研究对象,采用便携式索诺声M-turbo超声诊断仪经前囟门型颅脑超声检查,观察脓性脑膜炎、病毒性脑膜炎和结核性脑膜炎声像图改变特点及差异。

结果

化脓性脑膜炎及结核性脑膜炎脑膜回声异常阳性率为92.7%和100.0%,高于病毒性脑膜炎的20.0%,脑室扩张阳性率均为100.0%,高于病毒性脑膜炎的55.0%,积液阳性率为63.4%和75.0%,高于病毒性脑膜炎的5.0%,硬膜下积液阳性率为26.8%和12.5%,低于病毒性脑膜炎的95.0%,差异均具有统计学意义(χ2= 39.031、25.358、21.058、29.087,P均<0.01)。

结论

颅脑超声检查是新生儿中枢神经系统感染有效的诊断手段,对化脓性脑膜炎、结核性脑膜炎和病毒性脑膜炎影像学检查声像图改变较为清晰,诊断准确、方法简便、无创伤,是新生儿中枢神经系统感染辅助诊断及动态观察的有效手段。

Objective

To investigate the imaging characteristics of the brain ultrasound examination for cases with neonatal central nervous system infection.

Methods

Total of 69 cases with neonatal infection of the central nervous system were selected, the portable sonosite M-turbo ultrasonic diagnostic instrument was applied through anteriorfontanelle craniocerebral ultrasound. Changes of the characteristics and the differences of the imaging features of purulent meningitis, viral meningitis and tuberculous meningitis were analyzed, respectively.

Results

The positive rates of abnormal meningeal echo in purulent meningitis and tuberculous meningitis were 92.7% and 100%, which were higher than that of 20% in viral meningitis; ventricular dilatation positive rate was 100%, which was higher than that of 55% in viral meningitis; the positive rates were 63.4% and 75%, which was higher than that of 5% in viral meningitis, subdural effusion positive rates were 26.8% and 12.5%, which were lower than that of 95% in viral meningitis, all with significant differences (χ2 = 39.031, 25.358, 21.058, 29.087; P all < 0.01).

Conclusions

Brain ultrasound examination was an effective diagnostic method of central nervous system infection, imaging changes in the imaging examination of purulent meningitis, tuberculous meningitis and viral meningitis were clear, the diagnosis was accurate, which was simple and non-invasive, and an effective means to assist the diagnosis and dynamic observation of neonatal central nervous system infection.

表1 不同新生儿中枢神经系统感染脑膜回声异常声像图的改变
表2 不同新生儿中枢神经系统感染侧脑室扩张声像图改变的分布[例(%)]
表3 不同新生儿中枢神经系统感染其他声像图的改变[例(%)]
1
杨旭锦,周丛乐,汤泽中, 等. 新生儿感染性疾病与脑损伤的关系[J]. 中华围产医学杂志,2012,15(1):20-24.
2
罗雷,朱汝南,赵林清, 等. 人副肠孤病毒与儿童脓毒症和中枢神经系统感染的相关性[J]. 中华儿科杂志,2014,52(6):444-448.
3
赵军育,姜毅,侯新琳, 等. 降钙素原在诊断早期新生儿感染中的意义[J]. 实用儿科临床杂志,2012,27(2):122-124.
4
陆俊秀,陈敬国,陈海燕, 等. 颅脑超声与血清NSE对早产儿脑白质损伤诊断价值及二者相关性分析[J]. 临床儿科杂志,2012,30(9):836-839.
5
侯东敏,张铁娟,马建荣, 等. 超声诊断胎儿单纯性轻度侧脑室扩张的临床意义[J]. 中华妇产科杂志,2012,47(1):52-54.
6
Nigrovic LE, Fine AM, Monuteaux MC, et al. Trends in the management of viral meningitis at United States Children’s Hospitals[J]. Pediatrics,2013,131(4):670-676.
7
Srinivasan L, Shah SS, Padula MA, et al. Cerebrospinal fluid reference ranges in term and preterm infants in the neonatal intensive care unit[J]. J Pediatr,2012,161(4):729-734.
8
周丛乐. 颅脑超声在新生儿领域的应用[J]. 中国实用儿科杂志,2002,17(11):684-685.
9
张红爱,张惠芳,于淑群, 等. 新生儿化脓性脑膜炎的临床特点与早期诊断[J]. 实用儿科临床杂志,2012,27(14):1091-1092.
10
侯新琳. 新生儿梗阻性脑积水的诊断与治疗[J]. 中国新生儿科杂志,2014,29(2):127-130.
11
刘锟,马炎旭,张呈兵, 等. 小儿肠道病毒71型感染手足口病合并神经系统损伤的临床, MRI特征及随访研究[J]. 中华医学杂志,2012,92(25):1742-1746.
12
胡惠丽,胡冰,陈荷英, 等. 头颅磁共振成像在中枢神经系统白色念珠菌病诊治中的应用价值[J]. 中国当代儿科杂志,2014,16(8):834-839.
13
安庆华,郑玉明,孙志宝, 等. 3种诊断技术对中枢神经系统感染的诊断价值与临床意义比较研究[J]. 中华医院感染学杂志,2016,26(8):1721-1723.
14
韦巧珍,林宝利,苏萍, 等. 早产儿及足月儿化脓性脑膜炎临床特点比较分析[J]. 广西医科大学学报,2016,33(3):500-502.
15
李小玉,邓春,苏云娟. 98例足月儿、早产儿化脓性脑膜炎临床分析[J]. 第三军医大学学报,2013,35(19):2105-2107.
16
李杨方,赵晓芬,奚敏, 等. 新生儿化脓性脑膜炎病原学特征分析[J]. 中国新生儿科杂志,2015,30 (5):364-366.
17
李杨方,杜琨,吴玉芹, 等. 54例新生儿化脓性脑膜炎诊疗分析[J]. 中国小儿急救医学,2015,22(11):797-799.
18
石炼丽. 新生儿细菌性脑膜炎31例病原学及临床特征分析[J]. 中国基层医药,2012,19(24):3781-3782.
19
王肖茜,马敬斌,王道昉. 乳酸脱氢酶和降钙素原及C-反应蛋白联合检测在小儿中枢神经系统感染诊断中的意义[J]. 中国妇幼保健,2015,30(16):2545-2547.
20
冯国隽,杨红梅,王朝霞, 等. 彩色多普勒超声对新生儿颅脑疾病的诊断价值[J]. 西部医学,2016,28(4):556-559.
21
杨希,黄月,蒙萌, 等. 颅脑超声检查对高危新生儿颅内疾病的诊断价值[J]. 临床超声医学杂志,2014,16(4):268-270.
22
Laroche JP, Becker F, Khau-Van-Kien A, et al. Quality standards for ultrasonographic assessment of peripheral vascular malformations and vascular tumors. Report of the French Society for Vascular Medicine[J]. J Mal Vasc,2013,38(1):29-42.
23
BekiesińskaFigatowska M, BorszewskaKornacka MK, AntczakMarach D, et al. Regression of cystic lesions on brain MRI in a child with hypoxic-ischemic encephalopathy treated with selective head cooling[J]. Ginekologia Polska,2013,84(2):151-156.
24
Alderliesten T, Nikkels PG, Benders MJ, et al. Antemortem cranial MRI compared with postmortem histopathologic examination of the brain in term infants with neonatal encephalopathy following perinatal asphyxia[J]. Arch Dis Child Fetal Neonatal Ed NLM,2013,98(4):304-309.
25
Sarkar S, Askenazi DJ, Jordan BK, et al. Relationship between acute kidney injury and brain MRI findings in asphyxiated newborns after therapeutic hypothermia[J]. Pediatr Res,2014,75(3):431-435.
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