新生儿寒冷损伤综合征的血液动力学改变

HEMODYNAMIC CHANGE IN NEWBORN WITH COLD INJURY SYNDROME

本文运用Ｍ超及多谱勒技术，对１７例新生儿寒冷损伤综合征患儿 的血液动力学进行了动态观察。结果提示，低温（≤３５℃）时患儿心脏收缩功能减 弱，表现为Ｍ超ＬＰＥＰ延度及ＬＰＥＰ／ＬＶＥＴ比值增大；心输出量降低伴有肾动脉 血流速度及平均流速显著降低。复温后（３７℃）ＬＡ／ＡＯ值显著增加，心输出量等指 标恢复正常，提示寒冷损伤时新生儿心脏舒张期负荷增加，而且存在内脏相对缺 血。因此，认为对患儿在复温过程中给予改善微循环，适当应用正性肌力药物，可望 进一步改善预后。

Effects of cold injury on hemodynamic change were examined in 17 neonates by M ultrasonic wave and pulsed Doppler technique. The results showed that hypothermia (core body temperature≤ 35℃ ) weakened cardiac function of contraction, such us extension of LPEP and incrasing form of LPEP/LVET;and significantly decreased cardiac output,renal blood flow velocities (RDFV) and mean RDFV. Rewarming of the body to 37 ℃ significantly increased form of LA/AO compared with hypothermic state,and cardiac output ect. was recovered,there were indications that cardiac diastolic load increased in the pathophysiology of neonatal cold injury and ischemia in internal organs of the body.Therefore,the results suggest that treatment of improving microcirculation and using positive inotropic drug might further improved prognosis before the restoration of normal body temperature.