中华围产医学杂志
中華圍產醫學雜誌
중화위산의학잡지
CHINESE JOURNAL OF PERINATAL MEDICINE
2012年
12期
727-731
,共5页
陶子瑜%谢利剑%沈捷%肖婷婷%张永为%张儒舫%裘刚%龚小慧%陆海岚
陶子瑜%謝利劍%瀋捷%肖婷婷%張永為%張儒舫%裘剛%龔小慧%陸海嵐
도자유%사리검%침첩%초정정%장영위%장유방%구강%공소혜%륙해람
重症监护病房,新生儿%超声心动描记术%医疗决策帮助系统
重癥鑑護病房,新生兒%超聲心動描記術%醫療決策幫助繫統
중증감호병방,신생인%초성심동묘기술%의료결책방조계통
Intensive care units,neonatal%Echocardiography%Medical order entry systems
目的 探讨急诊床旁超声心动图在新生儿重症监护病房的应用价值. 方法 2007年1月至2011年7月,应用急诊床旁超声心动图(索诺声公司Micromax 1型便携式超声诊断仪或飞利浦iE33型彩色多普勒超声诊断仪)对668例有心脏病理性杂音、皮肤紫绀、气促等临床表现的患儿进行探查,以手术结果为金标准,评价急诊床旁超声心动图的诊断准确性及其在新生儿重症监护病房中的应用价值. 结果 668例患儿中男347例,女321例;足月儿309例,平均胎龄(39.1±0.6)周(37.0~42.1周);早产儿359例,平均胎龄(33.7±0.91)周(28.9~36.9周).患儿平均日龄为(7.2±1.3)d.共检出心血管异常507例,其中动脉导管未闭268例(早产儿232例,足月儿36例),先天性心脏病115例,持续胎儿循环99例,心律不齐25例.共54例行外科手术治疗,1例行介入手术治疗;手术成功51例,4例死亡.这55例手术患儿术前未进一步行CT、磁共振或创伤性心导管造影检查,直接行手术治疗.其余452例患儿经药物及时治疗后好转出院392例,无明显好转26例,死亡14例,放弃治疗20例.以手术结果为金标准,便携式超声诊断仪诊断先天性心脏病的准确率为94.5% (52/55),iE33型彩色多普勒超声诊断仪诊断准确率为96.4%(53/55). 结论 急诊床旁超声心动图能迅速评价危重患儿心脏结构功能及肺动脉压力,具有较高的临床价值.
目的 探討急診床徬超聲心動圖在新生兒重癥鑑護病房的應用價值. 方法 2007年1月至2011年7月,應用急診床徬超聲心動圖(索諾聲公司Micromax 1型便攜式超聲診斷儀或飛利浦iE33型綵色多普勒超聲診斷儀)對668例有心髒病理性雜音、皮膚紫紺、氣促等臨床錶現的患兒進行探查,以手術結果為金標準,評價急診床徬超聲心動圖的診斷準確性及其在新生兒重癥鑑護病房中的應用價值. 結果 668例患兒中男347例,女321例;足月兒309例,平均胎齡(39.1±0.6)週(37.0~42.1週);早產兒359例,平均胎齡(33.7±0.91)週(28.9~36.9週).患兒平均日齡為(7.2±1.3)d.共檢齣心血管異常507例,其中動脈導管未閉268例(早產兒232例,足月兒36例),先天性心髒病115例,持續胎兒循環99例,心律不齊25例.共54例行外科手術治療,1例行介入手術治療;手術成功51例,4例死亡.這55例手術患兒術前未進一步行CT、磁共振或創傷性心導管造影檢查,直接行手術治療.其餘452例患兒經藥物及時治療後好轉齣院392例,無明顯好轉26例,死亡14例,放棄治療20例.以手術結果為金標準,便攜式超聲診斷儀診斷先天性心髒病的準確率為94.5% (52/55),iE33型綵色多普勒超聲診斷儀診斷準確率為96.4%(53/55). 結論 急診床徬超聲心動圖能迅速評價危重患兒心髒結構功能及肺動脈壓力,具有較高的臨床價值.
목적 탐토급진상방초성심동도재신생인중증감호병방적응용개치. 방법 2007년1월지2011년7월,응용급진상방초성심동도(색낙성공사Micromax 1형편휴식초성진단의혹비리포iE33형채색다보륵초성진단의)대668례유심장병이성잡음、피부자감、기촉등림상표현적환인진행탐사,이수술결과위금표준,평개급진상방초성심동도적진단준학성급기재신생인중증감호병방중적응용개치. 결과 668례환인중남347례,녀321례;족월인309례,평균태령(39.1±0.6)주(37.0~42.1주);조산인359례,평균태령(33.7±0.91)주(28.9~36.9주).환인평균일령위(7.2±1.3)d.공검출심혈관이상507례,기중동맥도관미폐268례(조산인232례,족월인36례),선천성심장병115례,지속태인순배99례,심률불제25례.공54례행외과수술치료,1례행개입수술치료;수술성공51례,4례사망.저55례수술환인술전미진일보행CT、자공진혹창상성심도관조영검사,직접행수술치료.기여452례환인경약물급시치료후호전출원392례,무명현호전26례,사망14례,방기치료20례.이수술결과위금표준,편휴식초성진단의진단선천성심장병적준학솔위94.5% (52/55),iE33형채색다보륵초성진단의진단준학솔위96.4%(53/55). 결론 급진상방초성심동도능신속평개위중환인심장결구공능급폐동맥압력,구유교고적림상개치.
Objective To evaluate the clinical value of emergency bedside-echocardiography in neonatal intensive care unit.Methods Six hundred and sixty-eight infants with cardiac pathological murmurs,cyanosis and shortness of breath were detected by emergency bedside echocardiography (Sonosite Micromax 1 portable ultrasound or Philips iE33 ultrasonic systems) during January 2007 to July 2011.The accuracy of emergency bedside-echocardiography in the diagnosis of neonatal heart diseases was evaluated according to the results of surgical exploration.Results Among 668 enrolled neonates with the mean age of (7.2±1.3) d,there were 347 males and 321 females,and 309 term infants [mean gestational age (39.1±0.6) weeks (37.0~42.1 weeks)] and 359 premature infants [mean gestational age (33.7±0.91) weeks (28.9~36.9 weeks)].Totally,507 cases were found cardiac abnormality by emergency bedside-echocardiography,including 268 cases of patent ductus arteriosus (232 premature and 36 term infants),115 congenital heart disease,99 persistent fetal circulation and 25 arrythmia.Surgeries were performed on 54 infants and invasive therapy was performed on one infant,and none of them received CT,magnetic resonance imaging or invasive examinations before operation; among which,51 surgeries successed and 4 infants died.Other 452 infants were treated with medications,392 infants recovered and discharged,26 infants did not recover,14 cases died and 20 cases left the hospital before recovery.The accuracy rate of Micromax 1 portable ultrasound in diagnosing congenital heart diseases was 94.5% (52/55),while 96.4 % (53/55) for philips iE33 ultrasonic systems.Conclusions Emergency bedside-echocardiography could provide instant and valuable information of cardiovascular system,which would be helpful in making quick clinical decisions.