论文部分内容阅读
目的 研究肺出血新生儿心脏收缩功能和肺动脉压力变化及临床影响因素。方法 用M型二维超声多普勒和脉冲多普勒方法分别测定 2 8例肺出血新生儿和 2 8例非肺出血新生儿 (含 17例正常新生儿 )心脏收缩功能及主肺动脉血流速度频谱 ,以肺动脉血流峰速时间 /右室射血时间(TPV/RVET)比值反映肺动脉压力 ,分析肺出血新生儿心脏收缩功能和肺动脉压力变化及临床影响因素。结果 肺出血新生儿TPV/RVET比值 (0 2 5 3± 0 0 41)明显低于正常对照组 (0 32 9± 0 0 5 8)和非肺出血组 (0 30 1± 0 0 2 2 ) (P <0 0 1) ;肺出血新生儿恢复期该比值 (0 2 94± 0 0 33)升高 ,肺出血死亡组TPV/RVET比值 (0 2 19± 0 0 2 2 )和缩短分数 [FS(31± 5 ) % ]明显低于存活新生儿 (0 2 70± 0 0 31,TPV/RVET 39± 7,FS) (P <0 0 1) ;TPV(5 2± 12 )ms明显低于存活新生儿 (4 4± 8) (P <0 0 5 )。早产儿肺出血组TPV明显缩短 (P <0 0 1)。肺出血组TPV/RVET比值与动脉血pH值高度相关 (r=0 84,P <0 0 1)。结论 肺出血新生儿伴有肺动脉压力升高 ,严重者心脏收缩功能降低 ,导致心力衰竭 ,致新生儿死亡。
Objective To study the changes of cardiac systolic function and pulmonary arterial pressure in newborn infants with pulmonary hemorrhage and its clinical influencing factors. Methods M-type two-dimensional Doppler ultrasound and pulsed Doppler were used to measure the cardiac contractile function and the main pulmonary artery blood flow in 28 neonates with pulmonary hemorrhage and 28 neonates with non-pulmonary hemorrhage (including 17 normal neonates) The velocity spectrum was used to reflect the pulmonary arterial pressure by the ratio of peak pulmonary artery flow velocity to right ventricular ejection time (TPV / RVET). The changes of cardiac systolic function and pulmonary artery pressure in neonates with pulmonary hemorrhage and the clinical influencing factors were analyzed. Results The ratio of TPV / RVET in newborn infants with pulmonary hemorrhage was significantly lower than that in control group (0 32 9 ± 0 0 58) and non-pulmonary hemorrhage group (0 30 1 ± 0 0 2 2) (P0 02 19 ± 0 0 2 2) and shortening score (P 0 01). The ratio of newborn infants with pulmonary hemorrhage (0 2 94 ± 0 0 33) FS (31 ± 5)%] was significantly lower than that of surviving newborns (0 2 70 ± 0 0 31, TPV / RVET 39 ± 7, FS) (P 0 01) Surviving newborns (4 4 ± 8) (P <0 0 5). TPV was significantly shorter in preterm infants with pulmonary hemorrhage (P <0.01). The ratio of TPV / RVET in pulmonary hemorrhage was highly correlated with the arterial blood pH (r = 0 84, P 0 01). Conclusion Pulmonary hemorrhage in neonates with increased pulmonary artery pressure, severe heart systolic function decreased, leading to heart failure, resulting in neonatal death.