脉冲多普勒超声对新生儿窒息生命器官血流动力学变化的检测

研究新生儿窒息生命器官损伤的机理,提供早期诊断方法.方法 应用美国Ultramark—9型彩色超声诊断仪及丹麦ABL—500型血气分析仪等,对新生儿窒息脑、肾上腺及心脏等生命器官的血流动力学变化进行了有对照组的前瞻性研究.结果(1)窒息新生儿脑、肾上腺等的血液灌流量减少,尤以舒张期为甚.(2)窒息新生儿左、右心室的收缩和舒张功能均受到严重抑制,并表现为舒张功能首先受累,而收缩功能障碍则右室重于左室.(3)低氧血症的程度与脑及肾上腺血流速度减慢的程度是高度正相关(r=0.93,0.95,P<0.001),与左室射血分数降低的程度是高度正相关(r=0.91,P<0.001).结论 血流动力学紊乱是新生儿窒息生命器官损伤的主要原因,低氧血症是其血流动力学紊乱的病理生理学基础,超声检测其血流动力学变化,可用于新生儿窒息脏器损伤的早期诊断.

Study on Living Organs Hemodynamic in Neonates with Birth Asphyxia Using Pulse Doppler Ultra Sound

ve To study the pathogenesis of living organs in asphxiated neonates and to offer early diagnostic methods. Methods The author prospectively observed the variation of hemodynamics of cerebrum, adrenal gland and heart in asphyxiated neonates and healthy controls by using an Ultramark-9 ultrasongraph. Results (1)The blood perfusion of cerebrum and adrenal gland was decreased, especially that of diastolic period. (2)Cardiac dysfunction, predominately right ventricular dysfunction was serious in neonates after asphyxia. Also, the diastolic dysfunction appeared earlier then the systolic dysfunction did. (3)The degree of hypoxemia positively correlated with the degree of deceleration of blood flow velocity of brain and adrenal gland(r = 0.93, 0.95,P < 0.001) and with the degree of decrease in left ventricular ejectional fraction (r=0.91,P< 0.001). Conclusion The hemodynamic distrubance was the main reason for living organ injury in neonates with asphyxia. To observe the variation of blood flow using pulse doppler ultrasound can help diagnosis earlier.