超声评估早产儿动脉导管未闭对脑血流灌注影响的研究  

Evaluation on the influence of patent ductus ateriosus on cerebral blood flow infusion for preterm infants by ultrasound

作　　者：聂红莲[1] 郑剑[1] 方北[1] 李开林[1] 那丽娟[1] 张志刚[2] 卢庆晖[2] 

机构地区：[1]中山大学附属东华医院超声科,广东省东莞市523110 [2]中山大学附属东华医院新生儿科,广东省东莞市523110

出　　处：《临床超声医学杂志》2016年第8期525-528,共4页Journal of Clinical Ultrasound in Medicine

基　　金：东莞市科技计划医疗卫生重点项目(201210515000132)

摘　　要：目的探讨超声评价早产儿动脉导管未闭（PDA）对脑血流灌注影响的应用价值。方法 62例症状性PDA的早产儿分为动脉导管开放组（PDA组）30例和药物关闭动脉导管组（对照组）32例。在产后6-7 d应用常规超声结合低速血流显像技术,对两组患儿行超心动图和颅脑超声检查,测量大脑中动脉（MAC）、豆纹动脉（LSA）及豆纹动脉终末段（t LSA）的血流参数,包括收缩期峰值流速（Vs）、舒张末期速度（Vd）、平均血流速度（Vm）、收缩期峰值流速与舒张末期流速比值（S/D）及阻力指数（RI）;比较两组各参数的差别。结果 PDA组MCA、LSA、t LSA的Vd、Vm值均较对照组低,S/D、RI值均较对照组高,差异均有统计学意义（均P〈0.05）;PDA组t LSA的Vs值较对照组低,差异有统计学意义（P〈0.05）;两组MCA、LSA的Vs值比较差异无统计学意义。结论超声结合低速血流显像技术可观测PDA早产儿脑血流动力学改变,为临床判断和积极干预PDA提供依据。Objective To explore the value of ultrasound in evaluating the influence of patent ductus ateriosus（PDA）on cerebral blood flow infusion for preterm infants. Methods Sixty-two premature infants were divided into two groups, 30 patients were put in PDA group,32 patients were put in the control group, in this group, using medicine to close the PDA.Conventional ultrasound combined with E-flow imaging was performed to study the blood flow of MAC,LSA and t LSA. The parameters including Vs,Vd,Vm,S/D and RI were detected by color Doppler ultrasound. The difference between PDA group and control group was compared. Results The Vd and Vm of MCA,LSA and t LSA in PDA group were significantly lower than those in control group,S/D and RI of MCA,LSA and t LSA in PDA group was significantly higher than those in control group,there were significant difference（all P〈0.05）. There were no significant difference of Vs value of MCA and LSA between two groups. The Vs of t LSA in PDA group was significantly lower than that in control group（P〈0.05）. Conclusion Ultrasound combined with E-flow imaging can detect the change of cerebral hemodynamic in premature infants with PDA, and provide the useful parameters in clinic.

关 键 词：超声检查 低速血流显像技术 动脉导管未闭 早产儿 脑血流 

分 类 号：R722.6[医药卫生—儿科] R445.1[医药卫生—临床医学]