肠系膜上动脉和门静脉的多普勒血流测定：对新生儿坏死性小肠结肠炎早期预测的影响
Doppler flowmetry of the superior mesenteric artery and portal vein: impact for the early prediction of necrotizing enterocolitis in neonates.
作者信息
Urboniene Ausra, Palepsaitis Arvydas, Uktveris Rimantas, Barauskas Vidmantas
机构信息
Pediatric Surgery Department, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Radiology Department, Lithuanian University of Health Sciences, Kaunas, Lithuania.
出版信息
Pediatr Surg Int. 2015 Nov;31(11):1061-6. doi: 10.1007/s00383-015-3792-y. Epub 2015 Sep 29.
PURPOSE
Necrotizing enterocolitis (NEC) is a serious gastrointestinal disorder in newborns. Early diagnosis and rapid treatment is essential for seeking good outcome for neonates. The aim of our study was to evaluate intestinal blood flow in superior mesenteric artery (SMA) and portal vein (PV) in neonates with suspected or confirmed NEC and investigate the prognostic cut-off values to develop NEC.
METHODS
Doppler flowmetry of SMA and PV was performed for 62 newborns. Resistive (RI) and pulsatility (PI) indexes were measured in SMA as well as Volumetric blood flow (Vflow) in PV. ROC curves were applied to estimate sensitivity and specificity and to identify cut-off values.
RESULTS
There were 93.5% preterm neonates. 29 patients (46.8%) were diagnosed with NEC and 33 (53.2%) formed a control group. 96.3% NEC patients had RI >0.75 with sensitivity of 96.3% and specificity of 90.9% (OR 260). 88.9% NEC patients had PI >1.85 with sensitivity of 88.9% and specificity of 78.8% (OR 29). Portal Vflow lower than 37 ml/min was present in 89.7% patients with NEC (OR 11.7).
CONCLUSION
Intestinal blood flow Dopplerography can be a useful tool for diagnosing and predicting NEC.
目的
坏死性小肠结肠炎（NEC）是新生儿严重的胃肠道疾病。早期诊断和快速治疗对于新生儿获得良好预后至关重要。本研究的目的是评估疑似或确诊NEC的新生儿肠系膜上动脉（SMA）和门静脉（PV）的肠血流，并研究发生NEC的预后临界值。
方法
对62例新生儿进行SMA和PV的多普勒血流测定。测量SMA的阻力指数（RI）和搏动指数（PI）以及PV的容积血流量（Vflow）。应用ROC曲线评估敏感性和特异性并确定临界值。
结果
93.5%为早产儿。29例患者（46.8%）被诊断为NEC，33例（53.2%）为对照组。96.3%的NEC患者RI>0.75，敏感性为96.3%，特异性为90.9%（OR 260）。88.9%的NEC患者PI>1.85，敏感性为88.9%，特异性为78.8%（OR 29）。89.7%的NEC患者门静脉Vflow低于37 ml/min（OR 11.7）。
结论
肠血流多普勒检查可作为诊断和预测NEC的有用工具。
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