窒息新生儿心脏收缩时间间期的变化及其与临床和预后的关系

目的观察窒息新生儿心脏收缩时间问期(STI)的变化,探讨其与临床及预后的关系。方法采用二维及多普勒超声对轻度窒息27例、重度窒息18例及正常新生儿14例行二维超声及STI测定,并分析其与临床表现及预后的关系。结果与正常新生儿比较;轻、重度窒息组心脏的腔室大小和室壁厚度无变化(P>0.05)。轻、重度窒息组与正常新生儿相比,急性期右室射血时间(RVET)显著缩短(P<0.05);重度窒息组右室射血前期时问(RPEP)延长。重度窒息组RPEP/RVET急性期和恢复期均较正常和轻度窒息组明显增大(P<0.05)。急性期重度窒息组较正常新生儿的左室射血前期时间(LPEP)显著延长(P< 0.05)。急性期和恢复期重度窒息组RPEP/RVET增大患儿较轻度窒息组增多,急性期RPEP/RVET增大患儿心衰发生及远期致残率较RPEP/RVET正常增加。结论窒息对新生儿心功能的影响右心重于左心,RPEP/RVET增大者临床表现较重,致残可能性较大。

Changes of Systolic Time Interval After Neonatal Asphyxia and its Relationship with Clinical Manifestation and Prognosis

Objective To observe the changes of systolic time interval after neonatal asphyxia and explore its relationship with clinical manifestation and prognosis. Methods Tow-dimensional and Doppler echocardiography were employed to detect tow - dimension parameters and left and right ventricular STI in 27 mild and 18 severe asphyxiated neonates as well as 14 normal controls and its relationship with clinical manifestation and prognosis was analyzed. Results There was no difference in cavity and thickness of heart and great arteries between normal and asphyxiated neonates. In acute stage mild and severe asphyxiated neonates had a shorter right ventricular ejection time (RVET) than normal neonates and a longer right ventricular prejection period (RPEP) was found in severe neonates than that in normal and mild asphyxiated neonates. Left ventricular preejection time (LPEP) was prolonged in comparison with normal neonates in acute stage and convalescence. There were more cases with increased RPEP/RVET in severe asphyxiaed group than those in mild and normal group in acute stage. The incidence of heart failure in acute stage and disability in late period was higher in cases with increased RPEP/RVET than that with normal RPEP/RVET. Conclusion Asphyxia has more severe damage to right ventricle than that to left ventricle. Cases with increased RPEP/RVET are prone to suffering from heart failure in acute stage and more likely to undergo disability in late period.