床边心脏彩超在儿童重症监护室中心力衰竭患者的应用  

The Use of Bedside Cardiac Color Doppler Ultrasound for Children with Heart Failure in the Intensive Care Unit

作　　者：孙耀文 王辉[1] 徐秋琴[1] 丁粤粤[1] 侯翠[1] 司雪滢 顾培培 陈龙 李笑晨 SUN Yao-wen;WANG Hui;XU Qiu-qin;DING Yue-yue;HOU Cui;SI Xue-ying;GU Pei-pei;CHEN Long;LI Xiao-chen(Children's Hospital of Soochow University,Suzhou,Jiangsu,215025,China)

机构地区：[1]苏州大学附属儿童医院,江苏苏州215025

出　　处：《中国血液流变学杂志》2021年第4期546-548,563,共4页Chinese Journal of Hemorheology

基　　金：姑苏卫生人才(GSWS2020054,GSWS2019048);苏州市科技发展计划项目(SS2020066)。

摘　　要：目的探讨采用床边心脏彩超监测重症监护室内心力衰竭患儿的心脏功能变化及临床意义。方法选取内科重症监护室(PICU)的出现左心心力衰竭的患儿共43例,分别记录其入住后初次和末次的心超指标,按其结局分为好转组(n=23)和恶化组(n=20)。分别对两组的相关指标的变化进行比较。结果好转组入院初次心超结果中的CI和HR明显高于恶化组,差异有统计学意义(P<0.05)。好转组末次心超和初次相比,EF、CI明显升高,HR、HR/CI明显降低;恶化组末次心超和初次相比,HR明显升高,其余指标无明显变化。结论床边心脏彩超中HR和CI对于心衰患儿的转归有指示作用,通过床边心脏彩超计算心排量有望在重症监护室中得到进一步的临床推广应用。Objective To explore the use of bedside cardiac color Doppler ultrasound to monitor the changes in cardiac function and clinical significance of children with heart failure in the intensive care unit.Methods A total of 43 children with left heart failure in the Internal Medicine Intensive Care Unit(PICU)of Children's Hospital of Soochow University were selected,and the first and last echocardiograms were recorded after admission.According to their outcome,they were divided into an improved group(n=23)and worsened group(n=20)to compare the changes of the relevant indicators of the two groups.Results The CI and HR of the initial echocardiographic results in the improved group were significantly higher than those in the worsened group,and the difference was statistically significant(P<0.05).Compared with the initial echocardiography in the improved group,EF and CI were significantly increased,and HR and HR/CI were significantly reduced.Compared with the first echocardiography in the worsened group,the HR was significantly increased,and there were no significant changes in other indicators.Conclusion HR and CI in bedside cardiac color Doppler ultrasound are indicative of the outcome of children with heart failure.The calculation of cardiac output by bedside cardiac color Doppler ultrasound is expected to be further clinically applied in intensive care unit.

关 键 词：心力衰竭 心排量 心脏彩超 

分 类 号：R540.4[医药卫生—心血管疾病] R541.6[医药卫生—内科学]