电子心力测量法无创血流动力学在评估早产儿心功能中的应用

Application of Electronic Cardiac Force Measurement Method in Non-Invasive Hemodynamic Evaluation of Cardiac Function in Premature Infants

摘要: 目的：评估电子心力测量法(electrical cardiometry, EC)在早产儿心功能中的应用价值。方法：前瞻性选取2023年1月~2023年10月新疆医科大学第一附属医院新生儿科100例危重早产儿为研究组，50例无需呼吸机治疗的早产儿为对照组。所有早产儿在生后3天及7天均应用电子心力测量法监测心输出量(cardiac output, CO)及每搏输出量(stroke volume, SV)、心脏指数(cardiac index, CI)、心肌收缩力(ICON)、胸腔液体容量(thoracic fluid content, TFC)、外周血管阻力(systemic vascular resistance, SVR)；同时使用多普勒超声心动图法测定CO，分析两组血流动力学指标的变化情况，对比评价两种测量方法。结果：两组早产儿EC法或超声心动图均监测CO处于升高趋势；两组早产儿CO水平比较，研究组明显低于对照组患儿；其余血流动力学指标中，研究组的SV、CI、ICON均低于对照组，SVR、TFC明显高于对照组，差异均有统计学意义(P < 0.05)；CO在两种测量方法中差异无统计学意义(P > 0.05)。结论：EC法与超声心动图价值相当，可在床旁早期快速评估血流动力学状态及趋势变化，对于危重早产儿临床诊治有一定的价值。

Abstract: Objective: To evaluate the application value of electronic cardiac force measurement (Electrical Cardiometry, EC) in evaluating cardiac function in premature infants. Method: A prospective study was conducted on 100 critically ill premature infants in the neonatal intensive care unit of the First Affiliated Hospital of Xinjiang Medical University from January 2023 to October 2023, and 50 prem-ature infants in the general neonatal department of the First Affiliated Hospital of Xinjiang Medical University who did not require ventilator treatment at the same time were selected as the control group. All preterm infants used electronic cardiac force measurement at 3 and 7 days after birth to monitor cardiac output (cardiac Output, CO) and the output per stroke volume (stroke volume, SV), the cardiac index (cardiac index, CI), myocardial contractility (ICON), pleural fluid volume (thoracic fluid content, TFC), peripheral vascular resistance (systemic vascular resistance, SVR); CO using Doppler echocardiography, Analyzing the changes of the hemodynamic indexes in the two groups, Comparative evaluation of the two measurement methods. Result: Both groups of premature in-fants showed an increasing trend of CO with increasing age after birth, whether detected by EC method or echocardiography (P < 0.05); The CO levels of two groups of premature infants were compared, and the study group was significantly lower than the control group, with a statistically significant difference (P < 0.05); Among the other hemodynamic indicators, the SV, CI, and ICON of the study group were lower than those of the control group, while SVR and TFC were significantly higher than those of the control group, with statistical significance (P < 0.05); There was no statisti-cally significant difference (P > 0.05) between the two measurement methods for measuring CO on the same day. Conclusion: The EC method has a good correlation with echocardiography and can be used to monitor the trend changes of hemodynamic indicators in premature infants. It can quickly evaluate the hemodynamic status at the bedside and has certain value for the clinical diagnosis and treatment of critically ill premature infants.