РЕЗЮМЕЦель. Оценить влияние бронхолегочной дисплазии на прогноз перинатальных поражений головного мозга у детей, рождённых с очень низкой и экстремально низкой массой тела (ОНМТ и ЭНМТ), с учётом данных нейротрактографии.Материалы и методы. В данное исследование вошёл 61 ребенок, рожденный с ОНМТ и ЭНМТ. Было сформи-ровано две группы: I -22 ребенка с развившейся бронхолегочной дисплазией, II -39 детей, без бронхолегочной дисплазии. У всех детей имелось перинатальные поражения головного мозга гипоксически -ишемического генеза средней степени тяжести.Результаты. Достоверных различий в течение антенатального и интранатального периода в группах сравнения не выявлено. Период респираторной поддержки был достоверно продолжительнее у детей из первой группы. До-стоверного повреждения кортикоспинального тракта ни у одного ребенка не было выявлено.Заключение. В первые месяцы жизни восстановление и реабилитация детей, без развившейся бронхолегоч-ной дисплазии, происходит более интенсивно. Federation, 4 Sedina Street, Krasnodar, 350063, Russia; tel.: 8(961)5854353;.ru SUMMARY Aim. The purpose of the work is the study of the impact of bronchopulmonary dysplasia on the prognosis of perinatal brain injury in premature newborns with low and extremely low body weight considering the results of neurotractography. M. P. YAKOVENKO, E. I. KLESHENKO PREDICTIVE CAPABILITY OF NEUROTRACTOGRAPHY IN PREMATURE NEWBORNS WITH LOW AND EXTREMELY LOW BODY WEIGHT WITH MANIFESTING BRONCHOPULMONARY DYSPLASIA Department of Pediatrics with the course of neonatology FPD and PRS, FSBEI HE Kuban State Medical Umiversity of the Ministry of Health Care of the RussianMaterials and methods. 61 children born with low and extremely low body weight took part in our study. The first group included 22 newborns with manifesting bronchopulmonary dysplasia; the second group included 39 newborns without bronchopulmonary dysplasia. Perinatal brain injury of hypoxic-ischemic genesis of moderate severity was diagnosed in all cases.Results. Significant differences in groups during the antenatal and intrapartum periods were not detected. Period of respiratory support was significantly different in groups. Damage оf corticospinal tract was not detected by MRI.Conclusion. Rehabilitation of newborns without bronchopulmonary dysplasia was faster in the first months.
РЕЗЮМЕЦель. Установить структурные изменения головного мозга у недоношенных новорожденных, рожденных с низ-кой и экстремально низкой массой тела, с перинатальными повреждением головного мозга средней степени тяже-сти с помощью нейротрактографиии.Материалы и методы. Обследовано 48 детей, рожденных с ОНМТ и ЭНМТ, имеющих структурные изменения при проведении нейросонографии. Перед выпиской из отделения выхаживания проводилась нейротрактография.Результаты. Перед выпиской из отделений выхаживания у всех детей имелись транзиторные нарушения не-врологического статуса. При проведении нейротрактографии областью интереса явилось заднее бедро внутрен-ней сумки. У трех детей отмечалось снижение фракционной анизотропии (ФА) и увеличение измеряемого коэффи-циента диффузии (ИКД) в области интереса. К скорригированному возрасту 12 месяцев у детей с изменениями при проведении трактографии имелась задержка психомоторного развития.Заключение. Результаты нейротрактографии могут увеличить точность неврологического прогноза. Дети с от-сутствием значимых изменений при проведении нейротрактографии имеют благоприятный прогноз дальнейшего развития. Federation, 4 Sedina Street, Krasnodar, 350063, Russia; tel.: 8(961)5854353;.ru SUMMARY Aim. The objective of this study was to establish structural changes in the brain of preterm neonates born with low and extremely low body weight, with perinatal brain damage of moderate severity by neurotractography. M. P. YAKOVENKO, E. I. KLESHENKO CLINICOPATHOLOGIC CRITERIA OF PERINATAL BRAIN INJURY IN CHILDREN BORN WITH LOW AND EXTREMELY LOW BODY WEIGHT Department of Pediatrics with the course of neonatology FPD and PRS, FSBEI HE Kuban State Medical Umiversity of the Ministry of Health Care of the RussianMaterials and methods. 48 children born with very low and extremely low body weight were examined. Structural changes according to neurosonography were revealed in all. Neurotractography was performed before discharge from the nursing department.Results. A significant difference in the neurological status before discharge was not detected in children. The area of interest was the crus posterius capsulae internae during neurotractography. Reduction of FA and increase of ADC was detected in three cases. These children had a motormental retardation at the adjusted age of 12 months.Conclusions. Neuropathography results can increase the accuracy of later neurologic prognosis. If significant changes in the neurotractography are not recorded, then a favorable neurological prognosis is predicted
Aim. To determine the frequency of structural damage to the pyramidal tract in the region of crus posterius capsulae internae in children with a birthweight of less than one and a half kilograms with perinatal hypoxic damage to the nervous system using the value of fractional anisotropy according to diffusion-tensor magnetic resonance imaging at 39 weeks of post-conceptual age (PCA).Materials and methods. The study included 68 children born with a very low birthweight and 59 children with an extremely low birthweight demonstrating brain structural changes at 39 weeks of postconceptual age according to neurosonography. At 39 weeks of postconceptual age, the children included in the study underwent diffuse tensor magnetic resonance imaging (DT MRI) with the determination of fractional anisotropy.Results. At 39 weeks of PCA, all children had impaired neurological status. During DT MRI, the area of interest was crus posterius capsulae internae. Significant differences in the nature of structural damage to the pyramidal tract in the area of interest between children born with a very low and extremely low birthweight were not observed.Conclusion. Damage to the pyramidal tract was observed in 22.0% of children born with an extremely low birthweight, and in 13.2% of children born with a very low birthweight; partial destruction of the pathways was noted in 47.5% and 45.6% of children, respectively. Intact pyramidal tracts were visualized in 30.5% of children born with an extremely low birthweight and 41.2% of children born with a very low birhtweight.
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