儿童创伤后收缩性心功能超声改变  

Ehocardiographic changes of heart systolic function in children after trauma

作　　者：李梦婷 张铁凝 王丽杰[1] Li Mengting;Zhang Tiening;Wang Lijie(Pediatric Intensive Care Unit,Shengjing Hospital of China Medical University,Shenyang 110004,China;Pediatric Intensive Care Unit,West China Second Hospital of Sichuan University,Chengdu 610000,China)

机构地区：[1]中国医科大学附属盛京医院PICU,沈阳110004 [2]四川大学华西第二医院PICU,成都610000

出　　处：《中国小儿急救医学》2024年第12期888-893,共6页Chinese Pediatric Emergency Medicine

基　　金：辽宁省教育厅高校基本科研项目(LJ212410159095)。

摘　　要：目的了解儿童创伤后收缩性心功能超声改变及其与创伤程度的关系。方法前瞻性选取中国医科大学附属盛京医院2022年1月至2022年12月PICU收治的所有创伤患儿为研究对象。根据入院时创伤严重程度评分(ISS)分为轻中度创伤组(ISS≤25)和重度创伤组(ISS>25)。分别于入院72 h内(急性期)和转出PICU或出院时(恢复期)行经胸超声心动图检查。收集所有患儿的年龄、性别、创伤原因等临床信息, 比较轻中度创伤组和重度创伤组患儿急性期及恢复期左室各部位射血分数(EF)、运动幅度(位移)及其差值率。结果共纳入40例患儿, 男27例, 女13例, 中位年龄5(2, 8)岁;轻中度创伤组20例, 重度创伤组20例。轻中度创伤组急性期各部位EF、室间隔基底部位移及后壁各部位位移均低于恢复期(P<0.05);重度创伤组急性期各部位EF、室间隔位移及后壁中间部、心尖部位移均低于恢复期(P<0.05)。急性期重度创伤组基底部、中间部、短轴EF值低于轻中度创伤组(P<0.05);心尖部EF、后壁基底部位移低于轻中度创伤组, 但差异无统计学意义(P>0.05)。恢复期重度创伤组和轻中度创伤组各部位EF值比较, 差异均无统计学意义(P>0.05)。对于急性期与恢复期的差值率, 重度创伤组各部位EF差值率(P<0.05)和位移差值率(P>0.05)均大于轻中度创伤组。恢复期轻中度创伤组和重度创伤组心尖部、中间部、基底部EF值依次减低(P>0.05), 室间隔心尖部、中间部、基底部位移依次减低(P<0.05)。轻中度创伤组心尖部EF差值率及后壁心尖部位移差值率高于相应中间部和基底部差值率, 但差异无统计学意义(P>0.05)。结论儿童创伤后心脏收缩功能降低, 且改变呈节段性。创伤程度严重患儿, 心脏收缩功能降低更明显。Objective To analyse the ultrasound changes of heart systolic function after trauma in children and their relationship with the degree of trauma.Methods All children with trauma admitted to the PICU at Shengjing Hospital of China Medical University from January 2022 to December 2022 were prospectively selected as the research subjects.According to the injury severe score(IsS)at admission,they were divided into mild-moderate trauma group(ISS<25)and severe trauma group(ISS>25).Transthoracic echocardiography was performed within 72 hours of admission(acute phase)and upon transfer from the PICU or discharg(recovery phase).Clinical information,mainly including age,gender,and cause of trauma,was collected for all children.The ejection fraction(EF),motion amplitude(displacement),and difference rate of each segment of the left ventricle were compared between mild-moderate trauma group and severe trauma group in acute phase and recovery phase.Results A total of 40 children were included,including 27 males and 13 females with a median age of 5(2,8)years old.There were 20 children in the mild-moderate trauma group and 20 in the severe trauma group.The EF of each segment,displacement of the base of the ventricular septum,and displacement of each segment of the posterior wall in the mild-moderate trauma group in the acute phase were significantly lower than those in the recovery phase(P<0.05).The EF of each segment,displacement of the ventricular septum of each segment,displacement of the middle and apex segment of the posterior wall in the severe trauma group in the acute phase were significantly lower than those in the recovery phase(P<0.05).The EF values of the base,middle segment and short axis in the severe trauma group in the acute phase were significantly lower than those in the mild-moderate trauma group(P<0.05).The EF of the apex and displacement of the base segment of the posterior wall were lower than those in the mild-moderate trauma group,but the differences were not statistically significant(P>0.05).There was no

关 键 词：创伤 心功能 心脏超声 儿童 

分 类 号：R47[医药卫生—护理学]