液体控制对动脉导管未闭早产儿血流动力学的影响

摘要

目的 探讨液体控制对动脉导管未闭早产儿血流动力学的影响.方法 选择24周≤孕周<32周并为显著性动脉导管未闭患儿21例;记录液体控制前和E1液体控制24h E2后血流动力学和超声心动图变量.结果 患儿未行液体控制时E1液体摄入量为(144.8±14.9)mL/(kg·d),液体控制后总液体摄入量减至(108.1±10.6)mL/(kg·d),E1和已行液体控制时总液体摄入量差异性显著(P=0.015);E2时尿量明显低于E1时,差异有统计学意义(P=0.007);SVC流速E1时中位值为113.7mL/(kg·min),E2时中位值为63.3mL/(kg·min),E2时SVC流速显著性降低(P=0.003);患儿SMA在E1时平均血流速度为(0.25±0.03)m/s,明显高于E2时(0.14±0.04)m/s,且差异性显著具有统计学意义(P=0.011).结论 液体控制并未对早产儿肺循环或体循环血流动力学产生有益的影响.%Objective To study the effect of fluid control on hemodynamic among premature infants with patent ductus arteriosus.Methods 21 cases infant with patent ductus arteriosus and gestational age between 24 weeks to 32 weeks was selected for the study.Hemodynamic and echocardiographic variables were recorded 24 hours after fluid control and liquid control.Results Total fluid intake was (144.8±14.9)mL/kg/d (E1), and then decreased to (108.1±10.6)mL/kg·d(E2).There was significant difference in total liquid intake between E1 and E2 (P=0.015).The urine output in E2 was significant lower than that of E1(P=0.007).The median value is 113.7mL/kg/min when the SVC flow rate is E1.The median value is 63.3mL/kg·min when the SVC flow rate is E2.The SVC velocity decreased significantly at E2 (P=0.003).The mean blood flow velocity in the superior mesenteric artery (SMA) was (0.25±0.03)m/s at E1, which is significantly higher than that at E2 (0.14 + 0.04m/s).There was significant difference between E1 and E2(P=0.011).Conclusions Fluid control does not have beneficial effects on pulmonary circulation or systemic hemodynamics in premature infants.