摘要
目的寻求简便、快捷、准确的方法监测新生儿的心输出量，提高NICU中危重症患儿的血流动力学诊治水平。方法同时采用超声心输出量监测仪（Ultyasonic cardiac output monitor uscom，USCOM）和多普勒超声心动图（Echocardiography，ECHO）测量20例健康足月儿及29例早产儿生后28d内的心输出量，对测量结果使用Bland—Ahman分析法比较两种方法的一致性。结果Echo与Uscom测量足月儿组左心输出量时，两者的差值平均值和一致性区间为（30．6±51．1）ml／（kg·min），平均百分误差为21％。测量右心输出量时，两者的差值平均值和一致性区间为（-21．8±105）ml／（kg·min），平均百分误差为33．2％。两方法测量早产儿组左心输出量时，两者的差值平均值和一致性区间为（24．1±71．2）ml／（kg·min），平均百分误差为27．4％。测量右心输出量时，两者的差值平均值和一致性区间为（-29．5±192．9）ml／（kg·min），平均百分误差为51．8％。结论USCOM与ECHO测量新生儿左心输出量时，无论足月儿还是早产儿一致性均较好，且操作简便、快捷、无创。测量右心输出量两种方法一致性欠佳，在早产儿中尤甚。USCOM方法虽有一定误差，但临床上动态测宗判断抬势．有一定意义．研窬其与常规名普勤招声比拧有临床参考价值。
Objective To assess agreement （USCOM） and conventional echocardiography （ECHO） between the ultrasonic cardiac output monitor in the measurement of cardiac output in newborn infants, investigate the accuracy and clinical utility of the USCOM in healthy neonates. To explore a more convenient, faster, more accurate hemodynamic monitoring method, for improving the outcome of the critically ill neonates. Method From October 1^st,2011 to March 31^st,2012, a total of 49 infants were included, 20 were term infants, 29 were preterm infants. Cardiac outputs were measured by both ultrasonic cardiac output monitor and echocardiography in all the infants, 60 times measurements were done in both the term infants the preterm infants. The cardiac output of the left and right ventricles, heart rate, diameter and velocity time integral of the aortic valve and pulmonary artery valve of each infant were recorded. The consistency of two methods was analyzed as described by Bland-Ahman. Result Term the term infant group includea 20 term infants, 11 were male and 9 were female, the mean gestational age were （ 38. 1 ± 0. 56 ） weeks,mean age were （2 ± 1 ） days, mean weight were （3.2 ±0. 29 ） kg, mean Apgar score were 10. The mean left ventrieular output measured by Echo was （242. 3 ± 38.9） ml/（ kg · min）, measured by USCOM was （211.7±38.5） ml/（kg · min） ; The mean right ventricular output measured by ECHO was （318.9 ± 47.0）ml/（kg · min）, measured by USCOM was （340.7 ±76） ml/（kg · min） . Agreement between Echo and USCOM for left ventricular output （LVO） was （bias, -＋limits of agreement, mean % error） ： （30. 6 ± 51.1 ） ml/（ kg · min）, 21%, and for right ventricular output （RVO） ： （ - 21.8 ± 105 ） ml/（ kg · min）, 33.2%. The diameter of the aortic valve and pulmonary artery valve measured by conventional echocardiography were significantly larger than that estimated by ultrasonic cardiac output monitor （P 〈 0. 001 ）. The velocity time
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2013年第1期58-63,共6页
Chinese Journal of Pediatrics
基金
国家“十二五”科技支撑计划（2011BA111B22）
广东省科技计划项目（20090316）
