头颅超声在新生儿脑病治疗性低体温开始时的价值。
Value of cranial ultrasound at initiation of therapeutic hypothermia for neonatal encephalopathy.
机构信息
Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA.
University of Michigan, Ann Arbor, MI, USA.
出版信息
J Perinatol. 2022 Mar;42(3):335-340. doi: 10.1038/s41372-021-01233-0. Epub 2021 Oct 18.
OBJECTIVE
There is variation in the clinical practice for the use of cranial ultrasound (cUS) at the time of initiation of therapeutic hypothermia (TH) for neonatal encephalopathy. The role of cUS in selecting patients who may benefit from TH or excluding those where TH may impose risk is unknown.
STUDY DESIGN
A retrospective study was conducted on infants who received TH at a single tertiary center. Findings from cUS at initiation of TH were compared to findings from MRI following the completion of TH.
RESULTS
One hundred and eight infants were studied. Of the 55 with abnormalities on early cUS, 50 did not have corresponding MRI abnormalities. In contrast, 16 infants had some degree of intracranial hemorrhage detected on their MRI that was not noted on earlier cUS.
CONCLUSIONS
This study challenges whether cUS is an essential universal screening tool prior to the commencement of TH.
目的
在开始治疗性低体温（TH）治疗新生儿脑病时，颅超声（cUS）的临床应用存在差异。cUS 在选择可能受益于 TH 的患者或排除可能存在风险的患者方面的作用尚不清楚。
研究设计
对在一家三级中心接受 TH 的婴儿进行了一项回顾性研究。将 TH 开始时 cUS 的结果与 TH 完成后的 MRI 结果进行比较。
结果
共研究了 108 名婴儿。在 55 名早期 cUS 有异常的婴儿中，有 50 名没有相应的 MRI 异常。相比之下，16 名婴儿的 MRI 检测到某种程度的颅内出血，但早期 cUS 没有发现。
结论
这项研究对 cUS 是否是 TH 开始前的必要的普遍筛查工具提出了质疑。
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