分析合并PDA早产儿发生NEC的超声高危指标

Analysis of high risk sonography index in premature PDA patients with NEC

目的:探讨合并动脉导管未闭(PDA)早产儿发生出血坏死性小肠结肠炎(NEC)的超声高危指标。方法:回顾性分析2012年1月—2019年1月本院治疗的合并PDA早产儿发生NEC的患儿210例,分成保守治疗组、手术治疗组,均行心脏、腹部超声,分析各超声指标的差异。结果:保守治疗组:胎龄30~<35 W,体质量1500~<2000 g,Ra 0.5~<1,LA/AO 1.4~<1.6,SMA RI>0.7,腹部超声示局部肠管壁增厚,肠间少量透声差液暗区,肠蠕动差。手术组:胎龄<30 W,体质量<1500 g,发病日龄>20 d,Ra≥1,LA/AO≥1.6,SMA RI>0.9,腹部超声示多处肠管壁增厚、肠管扩张(>25 mm),肠间内见透声差积液(>15 mm),肠壁间积气。结论:早产儿胎龄<30 W,Ra:L-PDA,体质量<1500 g,LA/AO≥1.6,SMA RI>0.9,发病日龄>20 d,超声示肠壁间积气,警惕NEC需手术治疗可能。

Objective:To investigate the high risk sonography index in premature PDA patients with NEC.Methods:Retrospective analysis in January 2012 to January 2019 in our hospital for the treatment of premature infants with PDA was per-formed in 416 cases,divided into conservative group and operation group,which all received heart and abdominal ultrasound examination.Sonographic characteristics were analyzed.Results:In conservative group:gestational age 30~<35 W,body weight1500~<2000 g,Ra 0.5~<1,LA/AO 1.4~<1.6,SMA RI>0.7,abdominal ultrasound showed local intestinal tube wall thickening,mainly in the middle abdomen,a small amount of fluid in the intestine and fluid turbid,intestinal fixation and poor peristatic ability.In operation group:gestational age<30 W,body weight<1500 g,onset age>20 d,Ra≥1,LA/AO>1.6,SMA RI>0.9,the abdominal ultrasound showed multiple abdominal wall thickening,intestinal fixation,poor bowel movements,intestinal di-latation(>25 mm),seroperitoneum(>15 mm)fluid turbid,and interintestinal wall gas.Conclusion:For gestational age<30 W,Ra:L-PDA,body weight<1500 g,LA/AO>1.6,SMA RI>0.9,onset age>20 d,intestinal interwall gas accumulation on ultrasound was an indication of possible operation for NEC.