在患有动脉缺血性中风的新生儿中,不需要进行常规心声扫描
Indira Bhagat1, Rohan Sarkar2, Jayapalli R Bapuraj3
1Division of Neonatal-Perinatal Medicine, Central Michigan University, Mount Pleasant, Michigan.
American journal of perinatology
|January 3, 2024
概括
对于所有新生儿患有新生儿动脉缺血性中风 (NAIS) 的婴儿,可能不需要进行例行产后心声扫描. 可能导致NAIS的心脏异常通常在产前被检测出来,这使得产后心声谱在大多数情况下是多余的.
科学领域:
- 新生儿神经学 新生儿神经学
- 儿科心脏病学 儿科心脏病学
- 医学成像医学成像
背景情况:
- 目前的指导方针建议在急性阶段进行常规心声回声扫描 (ECHO),以确定新生儿动脉缺血性中风 (NAIS) 的心脏来源.
- 对NAIS的心血管栓塞起源的假设越来越受到质疑.
- 对于NAIS而言,产后ECHO的必要性值得怀疑,尤其是在广泛的产前异常查的情况下.
研究的目的:
- 为了确定患有NAIS的婴儿中显著心脏风险因素的患病率.
- 在常规胎儿异常扫描时代,评估在NAIS病例中常规产后ECHO的必要性.
主要方法:
- 通过脑MRI诊断出NAIS的54名婴儿的回顾性审查.
- 在急性阶段,所有婴儿都接受了心声回声扫描 (ECHO),以排除心脏起源.
主要成果:
- 产后ECHO没有发现心内血栓或植被.
- 只有5%的婴儿患有结构性心脏异常,所有这些都是由于综合征或染色体状况而在产前被诊断出来的.
- 复杂心脏异常的产前和产后检测率在统计上相似 (p=0.617).
结论:
- 对于所有患有NAIS的婴儿,可能不需要常规的产后ECHO治疗.
- 在正常胎儿扫描的婴儿中,ECHO的排除NAIS心脏来源的可能性很低.
- 产后ECHO只推用于NAIS婴儿,检测出染色体形.
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