摘要
目的:通过床旁超声评估动脉导管未闭(PDA)对早产儿脑血流动力学的影响。方法:选取100例PDA患儿为PDA组,同期80例健康早产儿为非PDA组,评估PDA对大脑前动脉(ACA)、大脑中动脉(MCA)、豆纹动脉的脑血流动力学参数的影响,以及2组早产儿脑室周围-脑室内出血(PIVH)的发生情况。结果:出生后7 d内对2组新生儿的脑血流动力学参数进行重复测量,发现与非PDA组比较,PDA组大脑ACA、MCA及豆纹动脉的舒张末期流速(Vd)、平均流速(Vm)显著降低,而收缩期峰值流速与舒张末期流速比值(S/D)和RI均增加(均P<0.05)。出生7 d后2组床旁颅脑超声示PDA组PIVH发生率(46.0%,46/100)明显高于非PDA组(15.0%,12/80)(P<0.05);PDA组重度PIVH发生率(17.0%,17/100)明显高于非PDA组(5.0%,4/80)。结论:PDA可改变早产儿脑血流动力学变化进而增加PIVH的风险;床旁超声通过评估脑血流变化,可为临床诊断和积极干预PIVH提供可靠依据。
Objective:To evaluate the effect of patent ductus arteriosus(PDA)on cerebral hemodynamics in premature infants by bedside ultrasound.Methods:A total of 100 PDA premature infants were selected as PDA group,80 cases of healthy premature infants in the same period were chosen as non-PDA group.The hemodynamic parameters of anterior cerebral artery(ACA),middle cerebral artery(MCA)and lenticulostriate artery and the occurrence of periventricular-intraventricular hemorrhages(PIVH)between the two groups were assessed.Results:Cerebral hemodynamic parameters of two groups of children were measured repeatedly within 7 days after birth.Compared with the non-PDA group,the end-diastolic velocity(Vd)and mean velocity(Vm)of the ACA、MCA and lenticulostriate artery decreased significantly in the PDA group while the ratio of peak systolic velocity to end-diastolic velocity(S/D)and RI increased,the differences were statistically significant(all P<0.05).Seven days after birth,the two groups of children were re-examined.Among the children in the PDA group,46 cases(46.0%)were found to have PIVH,and the incidence was significantly higher than that in the non-PDA group(15.0%),with statistically significant difference(P<0.05).Conclusions:PDA can change cerebral hemodynamics in premature infants and increase the risk of PIVH.Bedside ultrasound can provide a reliable basis for clinical judgment and active intervention in PIVH by assessing cerebral blood flow changes.
作者
曹喆
霍亚玲
胡蓉
王丹
CAO Zhe;HUO Yaling;HU Rong;WANG Dan(Department of Ultrasound,Children’s Hospital Affiliated to Zhengzhou University,Henan Children’s Hosipital,Zhengzhou Children’s Hosipital,Zhengzhou 450000,China)
出处
《中国中西医结合影像学杂志》
2020年第3期291-293,共3页
Chinese Imaging Journal of Integrated Traditional and Western Medicine
基金
河南省医学科技攻关计划(联合共建项目)(2018020612)。
关键词
动脉导管未闭
婴儿
早产
脑出血
超声检查
Ductus arteriosus
patent
Infants
premature
Cerebral hemorrhage
Ultrasonography
