彩色多普勒超声心动图对新生儿中央性青紫的评价

CAUSE CONFIDENCE IN NEONATAL CENTRAL CYANOSIS FROM ECHOCARDIOGRAPHY

新生儿青紫按病因分为生理性和病理性二类：后者因还原血红蛋白增多又分为中央性和周围性二种。本文就CFM对新生儿中央性青紫进行评价。225例新生儿中央性青紫中，心源性青紫95例，占42．7％，主要由各种复合性心脏畸形所致。肺源性青紫130例，占57.3％，主要由肺部疾患及新生儿窒息所致，少数由持续胎儿循环引起。患儿均有不同程度的青紫（平均SaO279．2％），气急者74．7％，心脏杂音者61．7％，经CFM检查，心源性紫绀中TGA占首位（45．2％），肺动脉闭锁或严重肺动脉狭窄居第二位（17.9％），危重型法洛氏心脏畸形为第三位（13．7％）。肺源性紫绀中，肺炎合并缺血缺氧性脑病居首位，其次为RDS合并缺血缺氧性脑病，居第三位是RDS伴呼吸衰竭。持续胎儿循环占9．2％。CFM为新生儿中央性青紫的首选检查手段。

To identify the cause of neonatal central cyanosis, 225 cases of central cyanotic neonates were detected by echocardiography during 1987-1994. There were 126 males and 99 females among them, aged from 2 days to 28 days (average 11. 8 days). and varied weight form 1200g-4350g(average 2925g). 95 cases (42.7%), were found to be cordiac cyanosis, include ing TGA 34 (35.8%) PA or oritical PS 17 (17. 9%), critical TOF 13 (13. 7%), DORV 8 (8. 4%), HIE+MA+VSD 5 (5.3%), AV Defect 4 (4. 2%), each of TAPVD, COA + PDA, Endocardial Fibrolastosis+ASD & Ebstein+ASD 3(3. 3%), and either of Cardiosple nia & DILV+ASD+VSD 1 (1.1 %). 130 cases (57.3%) were found to be pulmonary disease including pneumonia with HIE (26.9%). RDS with HIE (20%). RDS accompanied with respiratory failure (14. 6%). PFC (9. 2% ). We concluded echocardiography is the most use ful tool to arrive at a specific diagnosis in neonatal central cyanosis