动脉导管未闭早产儿餐后肠系膜上动脉血流速度改变与喂养不耐受的关系

The relationship between postprandial superior mesenteric artery blood flow velocities and feeding intolerance in preterm infant with patent ductus arteriosus

目的探讨动脉导管未闭早产儿餐后肠系膜上动脉血流速度的改变与喂养不耐受性之间的关系。方法采用彩色多普勒超声检查26例PDA早产儿从开始喂养至足量喂养时的餐前、餐后（30~60min）TAMV、PSV、EDV的变化,同时检查每例患儿PDA：LPA的比值,并分类。结果 7例为L-PDA,8例为M-PDA,11例为S-PDA,其中L-PDA组达到足量喂养的时间,每日呕吐的次数,胃潴留占每日喂养量的比率及明显腹胀的患儿比率与其他两组比较显著增加,餐后肠系膜上动脉TAMV、PSV、EDV的增幅少于其他两组,差异均有统计学意义（P〈0.05）。结论一定程度的动脉导管未闭（大PDA）对患儿餐后肠系膜上动脉的血流灌注影响较大而使喂养不耐受发生率增加。

Objective To explore the relationship between postprandial superior mesenteric artery blood flow velocities and feeding intolerance in preterm infant with patent ductus arteriosus. Methods Pulsed Doppler was used to measure the change of time-averaged mean velocity（TAMV）, peak systolic velocity（PSV） and end diastolic velocity（EDV） preprandially and postprandially（30 ~ 60 minute） from the beginning of feeding to adequate feeding in 26 preterm infants with PDA. At the same time, preterm infants were classified depend on the PDA： LPA（left pulmonary artery） ratio. Results Among 26 preterm infants, 7 infants were L-PDA, 8 infants were M-PDA, and 11 infants were S-PDA. Compared with M-PDA and S-PDA groups,the days reaching the full amount of feeding, times of daily vomiting, the percentage of gastric retention amount to the daily feeding amount and the percentage of infants with abdominal distention were significantly increased in L-PDA group（P〈0.05）. The increasing range of TAMV, PSV and EDV for postprandial superior mesenteric artery was significantly decreased in the L-PDA group（P〈0.05）. Conclusions Large PDA had more influences on the blood flow velocities of postprandial superior mesenteric artery, which increased the incidence of feeding intolerance.