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研究新生儿窒息生命器官损伤的机理,提供早期诊断方法.方法 应用美国Ultramark—9型彩色超声诊断仪及丹麦ABL—500型血气分析仪等,对新生儿窒息脑、肾上腺及心脏等生命器官的血流动力学变化进行了有对照组的前瞻性研究.结果(1)窒息新生儿脑、肾上腺等的血液灌流量减少,尤以舒张期为甚.(2)窒息新生儿左、右心室的收缩和舒张功能均受到严重抑制,并表现为舒张功能首先受累,而收缩功能障碍则右室重于左室.(3)低氧血症的程度与脑及肾上腺血流速度减慢的程度是高度正相关(r=0.93,0.95,P<0.001),与左室射血分数降低的程度是高度正相关(r=0.91,P<0.001).结论 血流动力学紊乱是新生儿窒息生命器官损伤的主要原因,低氧血症是其血流动力学紊乱的病理生理学基础,超声检测其血流动力学变化,可用于新生儿窒息脏器损伤的早期诊断.
To study the mechanism of neonatal asphyxia organ damage and provide an early diagnosis method.Methods Ultramarine-type ultrasound scanner and Denmark ABL-500 blood gas analyzer were used to detect neonatal asphyxia brain, adrenal gland and other vital organs Hemodynamic changes in the control group were prospective study.Results (1) asphyxia newborn brain, adrenal and other blood perfusion decreased, especially diastolic staggering. (2) asphyxia neonatal left and right ventricular Systolic and diastolic function were severely inhibited, and manifested as the first involvement of diastolic function, while contractile dysfunction, right ventricular weight is more than the left ventricle. (3) The degree of hypoxemia and brain and adrenal blood flow to slow the degree of (R = 0.93,0.95, P <0.001), which was positively correlated with the decrease of left ventricular ejection fraction (r = 0.91, P <0.001) .Conclusion The hemodynamic disorder is a vital organ of neonatal asphyxia Hypoxemia is the pathophysiology of hemodynamic disorders, the main cause of injury, ultrasound hemodynamic changes detected, can be used for early diagnosis of neonatal asphyxia injury.