超声心输出量监护仪监测脓毒症新生儿心功能的研究

目的 使用便携式超声心输出量监护仪(ultrasonic cardiac output monitor,USCOM)监测脓毒症新生儿的心功能变化.方法 使用USCOM测量32例轻度脓毒症新生儿、19例重度脓毒症新生儿及33例健康新生儿(对照组)心功能相关指标,比较3组心功能差异及所有脓毒症新生儿给予改善心功能治疗前后心功能变化的差异.结果 轻度脓毒症组、重度脓毒症组与对照组相比,心率、外周血管阻力高于对照组,心脏指数、心输出量、每搏输出量、主动脉峰流速低于对照组,差异有统计学意义(P<0.05).重度脓毒症组患儿心脏指数、心输出量、每搏输出量低于轻度脓毒症组患儿,差异有统计学意义(P<0.05).所有脓毒症患儿改善心功能治疗后心功能相关指标较治疗前改善,差异有统计学意义(P<0.05).结论 脓毒症新生儿存在早期心功能变化,使用USCOM可快速、简便、动态了解脓毒症新生儿的心功能及整体循环状态,为治疗及评估病情提供依据.

Ultrasonic cardiac output monitor for evaluation of cardiac function in neonatal sepsis

Objective To monitor the change of cardiac function in neonatal sepsis by using the ultrasonic cardiac output monitor(USCOM).Methods Thirty two cases of mild sepsis neonates and nineteen cases of severe sepsis neonates were enrolled and thirty three cases of healthy neonates were enrolled in the control group.The cardiac output indicators of three groups were monitored by USCOM.The differences of cardiac function among 3 groups and the changes of candiac function after treatment in septic neonates were investigated.Results Compared with control group,the heart rate,systemic vascular resistance of mild sepsis neonates group and severe sepsis neonates group were significantly higher,and the cardiac output,systolic volume,cardiac index,aortic peak velocity were significantly lower,the differences were statistically significant(P<0.05).The cardiac index,cardiac output were significactly lower in severe sepsis neonates group than those in mild sepsis neonates group(P<0.05).After improving cardiac function treatment,all cardiac function indexes of sepsis neonates were improved than before treatment,the differences were statistically significant(P<0.05).Conclusion There are significant cardiac function changes in sepsis neonates.The cardiac function and overall circulation state monitoring by USCOM is fast and convenient,and USCOM can provide the basis for treatment and evaluation of the neonatal sepsis.