The Application Value Of Ultrasound Monitoring ACA And MCA Hemodynamics In Varying Degrees Of Periventricular Intraventricular Hemorrhage

Objective: Periventricular-intraventricular hemorrhage(PIVH)is one of the main factors of early neonatal death and poor long-term prognosis.About 25% of Mel 50% of children with PIVH are prone to missed diagnosis because they have no obvious clinical symptoms.In recent years,studies have sho wn that even mild PIVH of grade Ⅰ and Ⅱ has the risk of poor prognosis,including mental retardation at school age.Therefore,early diagnosis and reasonable intervention are the key to a good prognosis.The purpose of this study was to retrospectively analyze the hemodynamic parameters of ACA and MCA in children with PIVH grade Ⅰ ~ Ⅳ and normal newborns from 2021.12 to 2022.12,and to explore the relationship between the changes of hemodynamic parameters of ACA and MCA and different degrees of PIVH in newborns.To evaluate the clinical significance of craniocerebral ultrasound monitoring the occurrence and development of PIVH and the hemodyn amic changes of ACA and MCA in the intervention treatment and prognosis of PIVH.Materials and methods: 1.Case data The newborns admitted to the general ward and intensive care unit of the neonatal department in a third-class hospital from 2021.12 to 2022.12 were collected.The gestational age before birth was 2 7-42 weeks(mean gestational age 32.0 ±2.1 weeks).The birth weight was 1.48-3.88 kg.1 minute Apgar score 5-9.100 newborns with no obvious abnormality in fetal ultrasonography and no obvious abnormality in heart and brain ultrasonography after birth were taken as the control group.According to Papile classification,PIVH children without severe congenital heart disease were divided into four groups: grade Ⅰ and Ⅱ,mild hemorrhage(n = 50),grade Ⅲ and Ⅳ,moderate to severe bleeding(n = 12)2.Instrument Using a portable color Doppler ultrasound diagnostic instrumen t(Instrument type,Vivid iq,American GE company),small and micro convex array probe with frequency of 2~5 MHz were used.3.Methods: During the examination,the children were in a resting state,and the anterior fontanelle and temporal fontanelle were used as sound transmission windows after cleaning and disinfection during craniocerebral ultrasound examination.the cerebral ventricle and brain tissue were scanned continuously in coronal plane,sagittal plane and cross section,and the blood flow parameters of ACA and MCA of PIVH grade Ⅰ ~ Ⅳ and control group were obtained.According to the data statistics of the blood flow parameters of the MCA on the affected side in the patients with unilateral PIVH,the blood flow parameters on both sides of the patients with bilateral cerebral involvement were basically the sam e,so the blood flow parameters of the left MCA were statistically analyzed in both the patients with bilateral PIVH and the control group.The gestational age,birth weight,1min Apagr score,mode of delivery,abnormal amniotic fluid and whether there is neonatal asphyxia were recorded.4.Statistical processing: The purpose of this study was to compare the differences of blood flow parameters of ACA and MCA among groups.The measurement data were compared by means of(mean ±standard deviation,(?) ±s).The independent sample t-test was used for the comparison between the two groups,and the counting data was expressed as frequency / percentage.Chi-square test was used to obtain the final results.Conclusion: 1.The hemodynamic changes of ACA and MCA in infants with PIVH were different from those in normal newborns,mainly in Vs,Vd and Volflow,but there was no significant difference in RI among groups.2.Compared with the control group,the Vs and Volflow indexes of ACA and MCA in the mild PIVH group were significantly higher than those in the control group,while the Vs,Vd and Volflow indexes of ACA in the severe PIVH group were significantly lower than those in the control group and mild group,while the Vs and Volflow of MCA in the severe PIVH group were not significantly different from those in the control group.3.Two-dimensional combined with Doppler ultrasound has a higher diagnostic specificity and sensitivity for PIVH compared to othe r intracranial haemorrhages,while dynamic monitoring of intracranial arterial haemodynamics in newborns can provide an important basis for the assessment of the onset and progression of PIVH.