超声心动图评估先天性左侧膈疝新生儿预后的价值  

Value of echocardiography in evaluating the prognosis of left-sided congenital diaphragmatic hernia in neonates

作　　者：赵丽娇[1] 孙锟[2] 武育蓉[2] 席丽丽[1] 吴力军[1] ZHAO Lijiao;SUN Kun;WU Yurong;XI Lili;WU Lijun(Department of Ultrasound in Medicine,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China;Pediatric Cardiology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China)

机构地区：[1]上海交通大学医学院附属新华医院超声中心,上海200092 [2]上海交通大学医学院附属新华医院小儿心血管科,上海200092

出　　处：《临床儿科杂志》2019年第7期481-484,共4页Journal of Clinical Pediatrics

基　　金：上海申康医院发展中心资助项目(No.SHDC12015102);上海交通大学资助项目(No.YG2015MS70);上海交通大学医学院资助项目(No.DLY201609)

摘　　要：目的 探讨超声心动图评估左侧先天性膈疝(CDH)新生儿预后的价值。方法 以2015年1月—2018年1月出生的左侧CDH新生儿为研究对象,回顾其一般情况及超声心动图资料,并按其生后30天是否存活分为存活组、死亡组,进行比较分析。结果 共纳入65例左侧CDH新生儿,存活组48例、死亡组17例。两组患儿胎龄及出生体质量、动脉导管持续右向左分流的比例、三尖瓣跨瓣压差、右肺动脉(RPA)及左室收缩末期(LVDd)内径差异均有统计学意义(P<0.05)。多元logistic回归分析发现,三尖瓣跨瓣压差及LVDd为不良预后的独立预测因子(P<0.05)。结论 超声心动图在评估左侧CDH新生儿的临床预后中有重要价值。Objective To explore the value of echocardiography in evaluating the prognosis of left-sided congenital diaphragmatic hernia (CDH) in neonates. Methods The left-sided CDH neonates born from January 2015 to January 2018 were selected as study subjects, and their general conditions and echocardiographic data were reviewed. According to whether the patients were alive 30 days after birth, they were divided into survival group and death group for comparative analysis. Results A total of 65 newborns with left-sided CDH were enrolled, including 48 in the survival group and 17 in the death group. Compared with the death group, the survival group had higher gestational age and birth weight, lower proportion of continuous right-to-left shunt of ductus arteriosus, lower trans-tricuspid pressure gradient, larger right pulmonary artery (RPA) diameter and left ventricular end-diastolic diameter (LVDd), and there were significant differences (P<0.05). Multivariate logistic regression analysis showed that trans-tricuspid pressure gradient and LVDd were independent predictors of poor prognosis (P<0.05). Conclusion Echocardiography plays an important role in evaluating the clinical prognosis of left-sided CDH in neonates.

关 键 词：超声心动图 左侧先天性膈疝 新生儿 

分 类 号：R722.1[医药卫生—儿科] R540.45[医药卫生—临床医学]