摘要
目的观察窒息新生儿心脏解剖及主、肺动脉血流参数的变化,探讨窒息对心脏收缩功能影响的特点及其意义。方法利用二维及多普勒超声对27例轻度窒息和18例重度窒息及14例正常新生儿进行二维超声及主、肺血流参数测定,并分析其与临床表现和预后的关系。结果急性期和恢复期,左室内径(LVD)、右室内径(RVD)、室间隔厚度(IVST)、左室后壁厚度(LVPWT)、主动脉内径(AO)和肺动脉内径(PA)正常新生儿组及轻、重度窒息组之间均无显著差异(P>0.05)。急性期重度窒息组主动脉最大射血速度(PV)较正常新生儿和轻度窒息组降低(P<0.01);主动射血加速时间(AT):重度窒息组较正常新生儿延长(P<0.05);肺动脉射血加速时间(AT)及与射血时间(ET)的比值(AT/ET):轻度窒息组较正常组,重度窒息组较轻度窒息组及正常组缩短或降低(P<0.01或<0.05)。恢复期除重度窒息组主动脉最大射血速度(PV)和肺动脉AT/ET仍低于正常新生儿组外,余参数各组间无差异。以急性期肺动脉AT/ET低于正常新生儿95%可信区间的下限0.26为标准,其估测窒息新生儿预后不良的敏感性、特异性及准确性分别为66.66%、79.66%和77.77%。结论窒息对新生儿的主、肺动脉血流参数均有影响,急性期肺动脉AT/ET的改变与患儿的预后有一定关系。
Objective To the observe changes of the aortic and pulmonary flow parameters after neonatal asphyxia and explore its relationship with clinical manifestations and prognosis. Methods Tow-dimensional and Doppler echocardiography was employed to detect anatomical and dynamic changes in 27 mild and 18 ,severe asphyxiated neonates as well as 14 normal controls and its relationship with clinical manifestation and prognosis in neonates with asphyxia was analyzed. Results There was no significant difference in LVD, RVD, LVPWT, IVST,AO and PA between normal and asphyxiated neonates. In acute stage, aortic peak velocity（PV） decreased in the severe asphyxia group compared with the mild and normal groups. Aortic acceleration time （AT） of the severe asphyxia group was prolonged compared with normal controls. The severe asphyxia group had a shorter acceleration time and higher minished ratio （AT/ET） of acceleration time （AT） to ejection time （ET） than either of normal or mild asphyxia group,so did the mild asphyxia group than those of the normal group. In convalescence, aortic peak velocity （PV） and pulmonary AT/ET still decreased compared with normal controls, The sensitivity, specificity and accuracy for predication of poor prognosis in asphyxiated cases were 66.66 %, 79.66 % and 77.77% respectively with the pulmonary AT/ET of asphyxiated cases in acute stage lower than 0.26, the low limit of 95 % confidence interval of normal controls. Conclusion Asphyxia has some damage to aortic and pulmonary flow parameters. There is some relationship between decreased pulmonary AT/ET in acute stage and poor prognosis .
出处
《临沂医学专科学校学报》
2005年第6期431-434,共4页
Journal of Linyi Medical College
关键词
新生儿
窒息
超声心动图
Neonate
Asphyxia
Echocardiography
