右室收缩时间间期观察分娩方式和肺部疾患对围产儿肺血流动力学变化的影响

RVSTI ASSESSMENT OF THE INFLUENCE OF MODES OF DELIVERY AND PULMONARY DISORDERS ON ADAPTING OF THE PULMONARY CIRCULATION TO EXTRA-UTERINE

本文用M型超声心动图连续测定生后5天内四组新儿生的右室收缩时间间期(RVSTI),发现:(1) 正常产儿随着时龄增长,RPEP、RICT缩短,RET延长,RPEP/RET、RICT/RET降低;(2) 剖宫产儿与正常产儿有类似趋势,仅RPEP/RET下降略晚于正常产儿;(3) 器械助娩儿组RPEP/RET和RICT/RET的下降较均正常产儿晚;(4) 肺疾患新生儿组两比值下降最晚。表明选择性剖宫产、胎头吸引器及产钳助娩、有肺部疾患的新生儿早期肺循环压力和阻力的下降都受到了影响。

RVSTI was measured in four groups of newborns within 5 days after birth. In vaginal born babies, as they grow older, RPEP and RICT are shortened, RET lengthened, RPEP/RET and RICT/RET decreased. These changes indicate the gradual decrease of perinatal physical high pulvascular pressure. The two ratios began decreasing at 6 hours and 12 hours after birth in vaginal newborns. A similar decrease occured in elective cesarean born babies, but the decrease of RPEP/RET is slightly later. In babies delivered by obstetrical forceps and suction apparatus and that suffered from pulmonary disorders, the decrease of the two ratios is much later than vaginal born babies. The present result demonstrates that these factors stated above have influence on the adaptation of the pulmonary circulation to extra-uterine.