超声心动图对早产儿动脉导管未闭封堵术后的左心室功能的改变分析

Analysis of the changes of left ventricular function after transcatheter closure of patent ductus arteriosus in premature infants by echocardiography

目的探讨超声心动图对评价早产儿动脉导管未闭治疗前后左心室功能变化的临床价值。方法选取我院新生儿80例有血流动力学意义的动脉导管未闭早产儿,根据治疗情况分为两组,动脉导管闭合组59例采用布洛芬治疗,动脉导管未闭组21例采用封堵术治疗。对比两组患儿一般资料、血流动力学参数和同组患儿治疗前后左心室功能参数、心脏血流动力学。结果两组患儿分娩方式和性别对比无差异(P>0.05);动脉导管闭合组患儿胎龄、压差、峰值流速、出生体重明显大于动脉导管未闭组,LA/AO值、动脉导管直径明显低于动脉导管未闭组(P<0.05)。治疗后动脉导管闭合组患儿左心室射血分数无明显变化(P>0.05);e'/a'比值、E/A比值明显升高,LA/AO比值明显降低(P<0.05)。治疗后动脉导管未闭组患儿左心室射血分数、e'/a'比值、E/A比值、LA/AO比值无明显变化(P>0.05);压差、流速明显提高,动脉导管直径明显缩小(P<0.05)。结论超声心动图能准确评估有血流动力学意义的动脉导管未闭早产儿封堵术治疗后心脏功能、结构变化情况,同时还具有无创、实时等优势,值得临床推广。

Objective To explore the clinical value of echocardiography in evaluating the left ventricular function of premature infants before and after the treatment of patent ductus arteriosus.Methods 80 premature infants with patent ductus arteriosus were selected from our neonatal intensive care unit(from 2017 to January 2019).According to the treatment,they were divided into two groups Ibuprofen was used to treat 59 cases in the closed group,21 cases in the group of patent ductus arteriosus were treated with occlusion.The general data and hemodynamic parameters of the two groups were compared with those of the same group before and after treatment.Results There was no difference in delivery mode and gender between the two groups(P>0.05);the gestational age,pressure difference,peak flow rate and birth weight of the children in the group with patent ductus arteriosus were significantly higher than those in the group with patent ductus arteriosus,and the LA/AO value and diameter of the artery ductus arteriosus were significantly lower than those in the group with patent ductus arteriosus(P<0.05).After treatment,there was no significant change in left ventricular ejection fraction(P>0.05);e'/a'ratio and E/a ratio increased significantly,LA/AO ratio decreased significantly(P<0.05).After treatment,the left ventricular ejection fraction,e'/a'ratio,E/a ratio and LA/AO ratio of children with patent ductus arteriosus had no significant change(P>0.05);the pressure difference and flow rate were significantly increased,and the diameter of ductus arteriosus was significantly reduced(P<0.05).Conclusion Echocardiography can accurately evaluate the changes of cardiac function and structure of premature infants with patent ductus arteriosus after oral occlusion treatment,and it also has the advantages of noninvasive and real-time,which is worthy of clinical promotion.