USCOM检测危重症新生儿左心功能的临床研究

Clinical value of USCOM in assessing left ventricular function of critically ill neonates

摘要:

目的 研究超声心输出量监测仪（USCOM）评定危重症新生儿左心功能的临床价值。方法 选取2017年1月—2018年12月遵义市第一人民医院收治的危重症新生儿73例作为研究对象。按照患儿有无休克分为无休克组和休克组，分别有34例和39例。另选取同期来该院体检的37例健康新生儿作为对照组。各组均应用USCOM监测左心功能，观察USCOM对危重症新生儿左心功能的临床评定价值。结果 各组心率、射血分数比较，差异无统计学意义（P >0.05）。休克组每搏输出量、每搏输出量指数、心输出量及心脏指数低于对照组和无休克组（P <0.05），无休克组每搏输出量、每搏输出量指数、心输出量及心脏指数低或短于对照组（P <0.05）。休克组速度峰值、速度时间积分及流动时间低或短于对照组和无休克组（P <0.05），外周阻力和血管阻力指数高于对照组和无休克组（P <0.05）；无休克组速度峰值、速度时间积分和流动时间低于对照组（P <0.05），外周阻力和血管阻力指数高于对照组（P <0.05）。结论 USCOM可有效监测危重症新生儿左心功能，分析患儿血流情况，为临床制订防治措施提供有力依据，值得临床应用及推广。

Abstract:

Objective To study the value of ultrasonic cardiac output monitor (USCOM) in assessing the left ventricular function of critically ill neonates.Methods Seventy-three critically ill neonates admitted to our hospital from January 2017 to December 2018 were selected and assigned to non-shock group (n = 34) and shock group (n = 39) according to the presence or absence of shock. Another 37 healthy neonates undergoing physical examinations in our hospital during the same period were enrolled as control group. USCOM was applied to monitor the left ventricular function, and the its clinical value for assessing the left ventricular function of critically ill neonates was analyzed.Results There was no difference in heart rate and ejection fraction among the groups (P > 0.05). The stroke volume, stroke volume index, cardiac output and cardiac index in the shock group were lower than those in the control group and the non-shock group (P < 0.05), and they were even lower in the non-shock group compared with the control group (P < 0.05). The peak velocity, velocity time integral, and flow time were lower, but the peripheral resistance and vascular resistance index were higher in the shock group than those in the control group and non-shock group (P < 0.05). Compared with the control group, the peak velocity, velocity time integral, and flow time were lower, but the peripheral resistance and vascular resistance index were higher in the non-shock group (P < 0.05).Conclusions USCOM is able to effectively monitor the left ventricular function and analyze the hemodynamics of critically ill neonates, thereby providing references for clinical interventions. Thus, USCOM should be more widely adopted in the clinical practice.