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目的: 研究新生儿多脏器损伤的机理, 提供早期诊断方法。方法: 应用Ultram ark-9 (HDI) 彩色超声诊断仪等研究同一窒息儿脑、肾、胃肠血流动力学和心脏功能的变化。结果: (1) 新生儿窒息后各脏器血液灌流量均减少, 但程度不一致, 以肠道最先受累且程度最重恢复最慢; (2) 心功能障碍是窒息的常见并发症, 其特点是舒张功能首先受累, 收缩功能障碍则右室重于左室; (3) 低氧血症是新生儿窒息的病理生理基础, 且与各脏器损伤的程度具有高度的相关性。结论:(1)血流动力学紊乱,血流量尤其舒张期血流量减少是新生儿窒息各脏器损伤的主要原因;(2) 新生儿在应激状态下不但生命与非生命器官间, 且在不同的非生命器官之间亦存在着血流再分布; (3) 超声检测各脏器血流动力学变化, 可用于新生儿窒息多脏器损伤的早期诊断。
Objective: To study the mechanism of neonatal multiple organ injury and provide early diagnosis. Methods: Ultram ark-9 (HDI) color ultrasonography was used to study the changes of hemodynamics and heart function in brain, kidney, gastrointestinal tract of the same asphyxia. Results: (1) After neonatal asphyxia, the blood perfusion of various organs decreased, but the degree was inconsistent, the intestinal tract was the first to be involved and the degree of recovery was the slowest; (2) Cardiac dysfunction was a common complication of asphyxia. Diastolic function is characterized by the first involvement, systolic dysfunction, right ventricular weight more than the left ventricle; (3) Hypoxemia is the pathophysiology of neonatal asphyxia, and with a high degree of correlation with the degree of organ damage. Conclusion: (1) hemodynamic disorders, blood flow, especially diastolic blood flow reduction is the main reason for neonatal asphyxia organ damage; (2) the neonatal under stress not only between life and non-living organs, and Blood flow redistribution also exists between different non-living organs. (3) Ultrasonography can detect the hemodynamic changes of various organs and can be used for the early diagnosis of neonatal asphyxiated multiple organ injury.