ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2020, Vol. 12 ›› Issue (4): 341-344.doi: 10.3969/j.issn.1674-3865.2020.04.018

• 临床研究 • 上一篇    下一篇

575例不同日龄和体质量新生儿的血流动力学指标的动态变化研究

黄惠娟，朱侨伟，简伟华，杨秀芳   

  1. 528400 广东 中山，中山大学附属中山医院新生儿科
  • 出版日期:2020-08-25 发布日期:2021-05-17
  • 通讯作者: 黄惠娟，E-mail：18902828616@189.cn
  • 作者简介:黄惠娟（1971-），女，医学硕士，主任医师。研究方向：新生儿疾病的诊治

Study on the dynamic change in hemodynamics indexes in 575 neonates of different days and different body weight

  • Online:2020-08-25 Published:2021-05-17

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摘要： 目的 应用超声心输出量监测仪（USCOM）动态监测无循环障碍新生儿心输出量（CO）、每搏输出量指数（SVI）、外周血管阻力指数（SVRI）、心脏指数（CI）、射血分数（EF）、每搏变异度（SVV）的动态变化，探讨应用USCOM动态监测的可靠性。
方法 测定2013年11月至2015年4月我院新生儿科收治的575例无循环障碍的新生儿1、3、7、14 d的CO、SVI、SVRI、CI、EF、SVV的动态变化，同时575例新生儿按体质量>2 500 g和体质量≤2 500 g分为1组和2组，再根据不同的日龄各分4组，分别为11、13、17、114组和21、23、27、214组。对各组的新生儿主动脉区和肺动脉区测量结果进行对比研究。
结果 体质量>2 500 g新生儿出生1 d和3 d测得的ASVI、ASVRI比较差异有统计学意义（P＜0.05）。其余指标比较差异无统计学意义(P>0.05);出生3 d和7 d测量结果仅ACI比较差异有统计学意义（P=0.03），其余指标均无统计学差异;出生7 d和14 d测量结果仅FEF、ASVV和FSVV比较差异无统计学意义(P>0.05)，其余指标比较差异均有统计学意义（P＜0.05）。体质量≤2 500 g的新生儿出生1 d和3 d测得的AEF、ACI、FSVI、FCO、FCI、FSVRI比较差异有统计学意义（P＜0.05），其余指标比较差异无统计学意义（P>0.05）;出生3 d和7 d测得的ACI、FCO、FCI比较差异有统计学意义（P＜0.05）。其余指标比较差异均无统计学意义（P>0.05）；出生7 d和14 d测得的所有指标比较差异均无统计学意义（P>0.05）。
结论 无循环障碍体质量>2 500 g的3～7 d新生儿和体质量≤2 500 g的7～14 d新生儿用USCOM测得的血流动力学指标变化不大，行血流动力学监测有一定的意义，出生1～3 d新生儿血流动力学变化不稳定，临床监测意义不大。

关键词: 无创血流动力学监测, USCOM, 心输出量, 外周血管阻力, 新生儿

Abstract: Objective To monitor the dynamic changes in the following indexes with ultrasonic cardiac output monitor(USCOM) in the neonates without circulatory disorder, including cardiac output, stroke volume index(SVI), systemic vascular resistance index(SVRI), cardiac index(CI),ejection fraction(EF) and stroke volume variation(SVV), and to study the reliability of USCOM for dynamic monitoring Methods A total of 575 neonates without circulatory disorder treated in our Neonatal Department from November 2013 to April 2015 were included, and the dynamic changes in CO,SVI,CI,SVRI,EF and SVV of these neonates were determined on 1,3,7 and 14 days after birth. Meanwhile these neonates were divided into two groups: group 1 with body weight over 2 500 g and group 2 no more than 2 500 g; they were also divided into 4 groups based on their days of age, which were group 11,group 13,group 17 and group 114,and group 21,group 23,group 27 and group 214.The results of the determination in aortic region and pulmonary artery region were compared among the neonates of the groups.
Results In the neonates of group 1, there was statistical difference in ASVI and ASVRI between 1-day neonates and 3-day neonates(P<0.05), while there was no statistical difference in the other indexes(P>0.05); only ACI had statistical difference between 3-day and 7-day neonates(P=0.03), and no statistical difference existed in the other indexes; there was no statistical difference in FEF, ASVV or FSW between 7-day and 14-day neonates(P>0.05), while the other indexes had statistical difference(P<0.05).In group 2,there was statistical difference in AEF,ACI,FSVI,FCO,FCI and FSVRI between 1-day and 3-day neonates(P<0.05),while there was no statistical difference in the other indexes(P>0.05); there was statistical difference in ACI,FCO and FCI between 3-day and 7-day neonates(P<0.05), while the difference in the other indexes was not statistically significant(P>0.05);between 7-day and 14-day neonates, there was no statistical difference in any index(P>0.05).
Conclusion For the neonates without circulatory disorder with body weight over 2 500 g at 3 to 7 days after birth and those no more than 2 500 g at 7 to 14 days after birth, there is no big difference in hemodynamic indexes, so the hemodynamic monitoring with USCOM is of some significance, but the changes in hemodynamic indexes in those at 1 to 3 days after birth are not stable, so there is not much significance in the monitoring.

Key words: Noninvasive hemodynamies monitoring, USCOM, Cardiac output, Systemic vascular resistance, Neonate