本文選題：新生兒　切入點：心室功能　出處：《安徽醫(yī)科大學》2012年碩士論文

【摘要】：目的(1)利用超聲心動圖檢測不同階段新生兒左右心室功能及血液動力學參數(shù)；(2)分析對正常新生兒心室功能的影響因素； 方法采用Philips IE33彩色多普勒超聲診斷儀檢測100例正常新生兒左右心室功能,其中,足月兒45例,早產(chǎn)兒55例。測量指標包括：左心室收縮功能指標有主動脈瓣口峰值流速(AV)、每搏輸出量(SV)、左室收縮末期容積(LVESV)、左室舒張末期容積(LVEDV)、左室短軸縮短率(LVSF)、左室射血分數(shù)(LVEF);右心室收縮功能指標有肺動脈瓣口峰值流速(PV)；左心室舒張功能指標有二尖瓣口舒張早期與舒張晚期血流充盈速度比(二尖瓣E/A,MVE/A);右心室舒張功能指標有三尖瓣口舒張早期與舒張晚期血流充盈速度比(三尖瓣E/A, TVE/A)。根據(jù)胎齡不同分成3組,即胎齡28-31+6、32-363+和37-41+6周,比較不同胎齡新生兒心室功能變化；根據(jù)心功能檢查時日齡分成2組,即dl-d7和d8-d28,分別比較不同日齡的早產(chǎn)兒和足月兒心室功能變化；采用多元線性回歸分析探討影響新生兒心室功能的因素。 結(jié)果(1)左心室收縮功能：AV、SV、LVESV、LVEDV、LVSF與LVEF隨胎齡增加而增加,且胎齡為28-313+與32-36++周組早產(chǎn)兒的AV、SV、LVESV、LVEDV、 LVSF與LVEF均低于37～41+6周組,差異有統(tǒng)計學意義(P均0.05)。另外,隨日齡變化,早產(chǎn)兒中AV、SV、LVESV、LVEDV、LVSF與LVEF隨之增加,組間比較差異有統(tǒng)計學意義(P均0.05)；足月兒LVSF與LVEF隨之增加,組間比較有統(tǒng)計學意義(P0.05)；其余各項差異均無統(tǒng)計學意義(P均0.05)。 (2)右心室收縮功能：PV隨胎齡增加而增加,且胎齡為28-313+及32-363+周早產(chǎn)兒組PV均低于胎齡為37-40+1周足月兒組,差異有統(tǒng)計學意義(P0.05)；早產(chǎn)兒中PV隨日齡增加而增加,組間比較差異有統(tǒng)計學意義(P0.05);足月兒組間比較PV差異無統(tǒng)計學意義(P0.05)。 (3)左心室舒張功能：MVE/A隨胎齡增加而增加,且胎齡為28-31+6及32-36+6周早產(chǎn)兒組PV均低于胎齡為37～40+1周足月兒組,差異均有統(tǒng)計學意義(P0.05)；早產(chǎn)兒中MVE/A隨日齡增加而增加,組間比較差異有統(tǒng)計學意義(P0.05)；足月兒組間比較MVE/A差異不顯著(P0.05)。 (4)右心室舒張功能：TVE/A隨胎齡增加而增加,且胎齡為28-31+6及32-36+6周早產(chǎn)兒組PV均低于胎齡為37～40+6周足月兒組,差異有統(tǒng)計學意義(P0.05)；早產(chǎn)兒中TVE/A隨日齡增加而增加,組間比較差異有統(tǒng)計學意義(P0.05)；足月兒組間比較TVE/A差異不顯著(P0.05)。 (5)正常新生兒心室功能的影響因素：AV、PV、SV、LVSF、LVEF、MVE/A及TVE/A均與出生體重、胎齡、檢查時日齡呈正相關(guān)(P均0.05)。另外,性別上,男嬰AV明顯高于女嬰,差異有統(tǒng)計學意義(P0.05),其他各項指標比較無統(tǒng)計學意義(P均0.05)；各項指標與出生方式無關(guān)(P均0.05)。 結(jié)論(1)隨胎齡的增大,新生兒左右心室收縮和舒張功能逐漸增強。 (2)新生兒生后左右心室收縮功能逐漸增強且左室收縮功能增加較右室明顯；左室舒張功能也漸增強,但右室舒張功能增強不顯著。 (3)早產(chǎn)兒心室舒縮功能均低于足月兒。 (4)出生體重、胎齡和日齡是影響新生兒心室功能的重要因素,而性別和出生方式不是影響心功能的主要參數(shù)。
[Abstract]:Objective ( 1 ) To detect left and right ventricular function and hemodynamics parameters in different stages by echocardiography .
( 2 ) influencing factors of normal neonatal ventricular function ;


Methods A Philips IE33 color Doppler ultrasonic diagnostic instrument was used to detect the left and right ventricular function in 100 normal neonates , including 45 cases of term infants and 55 premature infants . The measurement indexes include : the systolic function of left ventricle : the peak velocity of the aortic valve ( AV ) , the volume of each stroke ( SV ) , the end diastolic volume ( LVL ) of the left ventricle , the left ventricular end diastolic volume ( LVSF ) , the left ventricular ejection fraction ( LVEF ) , and the right ventricular systolic function index ( PV ) ;
The diastolic function of left ventricle was earlier than that of mitral valve E / A , MVE / A and tricuspid valve E / A , TVE / A . According to the gestational age , three groups were divided into three groups : gestational age 28 - 31 + 6 , 32 - 363 + and 37 - 41 + 6 weeks .
According to the cardiac function , the ventricular function changes of preterm infants and term infants with different age were divided into 2 groups , i.e . , dl - 7 and d8 - d28 , respectively .
Multivariate linear regression analysis was used to investigate the factors affecting neonatal ventricular function .

Results ( 1 ) Left ventricular systolic function : AV , SV , LVET , LVSF and LVEF were increased with the gestational age .
LVSF and LVEF increased with the increase of LVEF ( P0.05 ) .
There was no significant difference in the remaining differences ( P < 0.05 ) .

( 2 ) Right ventricular systolic function : PV increased with the gestational age , and the gestational age was 28 - 313 + and 32 - 363 + week premature infants group PV was lower than the gestational age at 37 - 40 + 1 week ( P0.05 ) .
In preterm infants , PV increased with age , and there was significant difference between groups ( P0.05 ) . There was no statistical significance between the groups in term infants ( P0.05 ) .

( 3 ) Left ventricular diastolic function : MVE / A was increased with the gestational age , and the PV of preterm infants with gestational age of 28 - 31 + 6 and 32 - 36 + 6 weeks was lower than that in gestational age of 37 锝，

本文編號：1712486