超声检测新生儿动脉导管未闭的临床价值

Clinical value of echocardiography in diagnosis of patend ductus arteriosus in newborn

目的:动态观察新生儿动脉导管关闭的时间,新生儿动脉导管生理及病理特点,为临床早期诊断动脉导管未闭(PDA)提供准确依据。方法:应用彩色多谱勤超声心动图对出生24h～7d的新生儿(I组)及6个月～3岁患儿(Ⅱ组)未闭的动脉导管的内径、收缩期最大血流速度进行测量,并比较测量结果,连续三次动态观察新生儿动脉导管关闭情况。结果:新生儿动脉导管多数可自然关闭,关闭时间多在24～72h,少数3d后关闭。本组仅1例经4月的连续观察,动脉导管依然未闭。未闭的动脉导管内血流速度I组与Ⅱ组比较差异有显著性(P<0.001)。结论:多普勤超声心动图不仅能早期诊断PDA,也可进行跟踪观察,动态检测动脉导管的关闭时间,对诊断PDA具有重要价值。

Objective：To supply accurate evidences for early diagnosis of patent duchus arteriosus （PDA） by dynamically monitoring the physiologic and pathologic characteristics,and closing time of PDA with echocardiography. Methods：The subjects were divided into two groups（group l aging from 24h to 7 d,group 2 aging from 6 months to 3 years）. The diameters and the peak systolic velocity （Vmax） of blood flow in ductus arteriosus as well as the systole function of left ventricle of all subjects were observed. We also monitored the closing time of ductus arteriosus of newbom for 3 times. Results：In many cases the patent ductus arteriosus could close spontaneously during 24～ 72h while few cases closed after 3d. The Vmax of blood flow in ductus arteriosus of the two groups were significantly different （P0.01）. Conclusion：Echocardiography can be applied not only for early diagnosis of PDA,but also for successively nonitoring its closing time. So it is very valuable in the diagnosis of PDA.