心肺联合重症超声预测早产儿ARDS患者预后的价值分析

Value Analysis of Cardiopulmonary and Intensive Ultrasound in ARDS Patients with Premature Infants

目的:分析心肺联合重症超声预测早产儿急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)预后的价值。方法:将我院2019年7月-2021年7月收治的240例重症监护室ARDS早产儿作为预测对象,根据预后结果进行分组,并建立存活组与死亡组,存活组(n=206)和死亡组(n=34)全部早产儿均实施心肺联合重症超声诊断,观察该诊断方式下呼吸参数和血流动力学参数。结果:存活组(n=206)和死亡组(n=34)观察潮气量、气道平台压、气道峰压、呼气末正压、内源性呼吸末正压、动脉二氧化碳分压、PH、呼吸频率等指标存在显著差异,有统计学意义(P<0.05)。两组早产儿左心室舒张末内径、右室舒张末期内径、左室射血分数、右心室射血分数、三尖瓣环收缩期位移和SM等指标存在显著差异,有统计学意义(P<0.05)。结论:针对ARDS早产儿,联合使用心肺与重症超声进行预测,可确定其呼吸状况和血流动力学状况,并且可为患者预后和病死率预测提供指导。同时重症超声具有操作简单、可重复性强等使用优势,该诊断方式在临床中具有推广应用价值。

Objective:to analyze the value of cardiopulmonary combined with severe ultrasound in predicting the prognosis of acute respiratory distress syndrome(ARDS)in preterm infants.Methods:This study took 240 premature infants with ARDS in intensive care unit treated in our hospital from July 2019 to July 2021 as the prediction object,grouped them according to the prognosis results,and established the survival group and death group.All premature infants in the survival group(n=206)and death group(n=34)were diagnosed by cardiopulmonary combined severe ultrasound,and the respiratory parameters and hemodynamic parameters were observed.Results:in the survival group(n=206)and the death group(n=34),tidal volume(VR),plateau pressure(pplat),peak airway pressure(ppeak),positive end expiratory pressure(PEEP),endogenous positive end expiratory pressure(PEEPi)were observed There were significant differences in arterial partial pressure of oxygen(PaCO2),pH and respiratory rate(RR)(P<0.05).Left ventricular end diastolic diameter(LVEDd),right ventricular end diastolic diameter(rvedd),left ventricular ejection fraction(LVEF),right ventricular ejection fraction(RVEF)There were significant differences between tricuspid annular systolic displacement(TAPSE)and Sm(P<0.05).Conclusion:In the diagnosis of premature infants with ARDS,the combination of cardiopulmonary and severe ultrasound can determine their respiratory and hemodynamic conditions,and provide guidance for the prediction of prognosis and mortality.At the same time,severe ultrasound has the advantages of simple operation and strong repeatability.This diagnostic method has the value of popularization and application in clinic.