多普勒超声对持续气道正压治疗婴儿室间隔缺损合并心力衰竭心功能的评价  

Assessment of Cardiac Function by Doppler Echocardiography with Nasal Continuous Positive Airway Pressure in Ventricular Septal Defect Infants with Congestive Heart Failure

作　　者：王芳韵[1] 崔威[1] 金兰中[1] 陈贤楠[2] 

机构地区：[1]首都医科大学附属北京儿童医院超声科,100045 [2]首都医科大学附属北京儿童医院急救中心,100045

出　　处：《中国超声医学杂志》2002年第6期433-436,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 :借助多普勒超声评价持续气道正压 (NCPAP)对于改善室间隔缺损 (VSD)合并充血性心力衰竭 (CHF)患儿心功能的疗效。方法 :对危重症监护病房的年龄在 1.5～ 9月之间的 9例 VSD合并 CHF患儿 ,借助超声心功图测定基础状态心功能的各项指标 ;应用 NCPAP 30分钟后依同法测定各项指标的变化值 ;停止 NCPAP2 0～ 30分钟 ,观察各项指标的变化。结果 :治疗后本组患儿左心室泵血功能提高 ,每搏输出量 (SV)由 (10 .4 7±1.80 ) ml升至 (12 .11± 2 .0 3) ml,心输出量 (CO)由 (1.79± 0 .2 8) L / min升至 (1.91± 0 .2 9) L / min (P均 <0 .0 0 1) ,主动脉血流峰值速度 ,平均速度以及主动脉速度时间积分均提高 (P均 <0 .0 1)。左心室舒张功能改善 ,等容舒张时间 (IRT)由 (0 .0 86± 0 .0 0 6 ) s缩短至 (0 .0 6 7± 0 .0 0 3) s,E峰加速时间 (AT- E)由 (6 9.2 2± 8.6 9) ms缩短至 (6 0 .89± 8.31) ms(P均 <0 .0 0 1) ,E峰流速 (EPV)及 E/ A升高 ,E充盈分数 (EFF)升高而 A充盈分数(AFF)下降。暂停 NCPAP治疗后 ,上述心功能指标恢复到治疗前水平。结论 :应用多普勒超声技术动态测定心脏SV、CO及 IRT等反映心功能的指标具有快速、准确、重复性强等优点 。Objective:To evaluate the cardiac function of nasal continuous positive airway pressure(NCPAP) in infants with congestive heart failure (CHF) secondary to VSD by Doppler echocardiography.Methods:Nine infants diagnosed of VSD with CHF were sedated and given NCPAP. Cardiac function was determined by Doppler echocardiography at baseline and while on NCPAP.Results:Nine infants aged 4 4±2 4 months were all diagnosed of CHF secondary to VSD, after the application of NCPAP, significant increase was found in systolic function : stroke volume(SV) and cardiac output(CO) rose from10 47±1 80ml to 12 11±2 03ml,1 79±0 28L/min to 1 91±0 29 L/min ( P <0 001)respectively. Improvement in diastolic function of left ventricle was evidenced as decreased of corrected isovolumic relaxation time(IRT) and E acceleration time( P <0 001), increased E peak velocity(EPV) and E/A An increase in E flow fraction(EFF) and a decrease in A flow fraction (AFF) were also observed.All variables returned to baseline after cessation of NCPAP.Conclusions:Doppler echocardiography is of great value for estimation of cardiac function in intensive care unit.

关 键 词：多普勒超声心动图 室间隔缺损 充血性心力衰竭 持续气道正压 心功能 婴儿 

分 类 号：R445.1[医药卫生—影像医学与核医学]