Cerovac-Cosić Natasa, Todorović Slobodanka, Jović Nebojsa, Prostran Milica
Klinika za neurologiju i psihijatriju za decu i omladinu, Medicinski fakultet, Beograd.
Vojnosanit Pregl. 2003 May-Jun;60(3):291-7. doi: 10.2298/vsp0303291c.
Establishing the value of neurological examination, and additional diagnostic methods (ultrasonography and magnetic resonance imaging of the brain) in the diagnosis and prognosis of hypoxic-ischemic encephalopathy and its treatment, tracking the clinical course, and making the prognosis of neurological development in newborn infants with hypoxic-ischemic encephalopathy.
The group of 40 term newborn infants with suspected intrauterine asphyxia was examined. All the infants were prospectively followed until the 3rd year of age at the Clinic for Neurology and Psychiatry for Children and Youth in order to estimate their neurological development and to diagnose the occurrence of persistent neurological disorders. All the infants were analyzed by their gestational age and Apgar score in the 1st and the 5th minute of life. They were all examined neurologically and by ultrasonography in the first week of life and, repeatedly, at the age of 1, 3, 6, 9, 12, 18, as well as in the 24th month of life. They were treated by the standard methods for this disease. Finally, all the infants were examined neurologically and by magnetic resonance imaging of the brain in their 3rd year of age. On the basis of neurological finding infants were divided into 3 groups: infants with normal neurological finding, infants with mild neurological symptomatology, and infants with severe neurological disorders.
It was shown that neurological finding, ultrasonography and magnetic resonance imaging of the brain positively correlated with the later neurological development of the infants with hypoxic-ischemic encephalopathy.
Only the combined use of these techniques had full diagnostic and prognostic significance, emphasizing that the integrative approach was very important in the diagnosis of brain lesions in infants.
确定神经学检查以及其他诊断方法（脑部超声检查和磁共振成像）在缺氧缺血性脑病的诊断、预后及其治疗中的价值，追踪临床病程，并对缺氧缺血性脑病新生儿的神经发育进行预后评估。
对40名疑似宫内窒息的足月儿进行了检查。所有婴儿均在儿童和青少年神经精神病诊所进行前瞻性随访，直至3岁，以评估其神经发育情况并诊断持续性神经障碍的发生。根据胎龄和出生后第1分钟及第5分钟的阿氏评分对所有婴儿进行分析。在出生后第一周以及1岁、3岁、6岁、9岁、12岁、18岁和24个月时，对他们进行神经学检查和超声检查。他们接受了针对该疾病的标准治疗方法。最后，在3岁时对所有婴儿进行神经学检查和脑部磁共振成像检查。根据神经学检查结果，将婴儿分为3组：神经学检查结果正常的婴儿、有轻度神经症状的婴儿和有严重神经障碍的婴儿。
结果表明，神经学检查结果、脑部超声检查和磁共振成像与缺氧缺血性脑病婴儿的后期神经发育呈正相关。
只有联合使用这些技术才具有充分的诊断和预后意义，强调综合方法在婴儿脑部病变诊断中非常重要。
