Behnke Simone, Robel-Tillig Eva
Chirurgie, Kreiskrankenhaus Torgau Johann Kentmann gGmbH, Torgau.
Klinik für Kinder und Jugendliche, Sozialstiftung Klinikum Bamberg, Bamberg.
Z Geburtshilfe Neonatol. 2020 Aug;224(4):199-207. doi: 10.1055/a-1101-9783. Epub 2020 Mar 31.
Hypovolemia is one of the important problems in sick neonates. Ultrasound is a safe, noninvasive diagnostic tool for the assessment of volume status. For that reason, the aim of the study was to determine normal values of the diameter of inferior vena cava (IVC), abdominal aorta (Ao) and the index IVC/Ao.
97 healthy, term neonates were included in the study and investigated at first and third day of life. The diameter of IVC, Ao was measured and the index from IVC/Ao was estimated. Using statistics mean and median values of the parameters and correlations to birth weight were determined.
Diameter of Ao at first day was 6.1 (+/-0.6) mm and at third day 6.2 (+/-0.6) mm, of IVC at first day was 2.5 (+/-0.5) and at third day 2.61 (+/-0.5). The Index from diameters of IVC/Ao was evaluated at day 1 as 0.4 (+/-0.1) and day 3 as 0.4 (+/-0.1). We found a positive correlation to the birth weight. We identified a significant difference of the index in SGA and LGA - neonates (0.36 vs 0.47). Despite a significant reduced weight from first to third day in the neonates, we determined no influence on the diameter of IVC, Ao and the index IVC/Ao.
We determined normal values of diameter of IVC and Ao and the Index of IVC/Ao. It is our opinion, that it is possible to assess the intravascular volume using the index. The importance of the index can be underlined by the results in SGA-neonates. More research is needed to understand some points of the pathophysiology in SGA.
低血容量是患病新生儿的重要问题之一。超声是评估容量状态的一种安全、无创的诊断工具。因此，本研究的目的是确定下腔静脉（IVC）、腹主动脉（Ao）直径及IVC/Ao指数的正常值。
97例健康足月儿纳入本研究，并在出生第一天和第三天进行检查。测量IVC、Ao的直径，并估算IVC/Ao指数。采用统计学方法确定参数的均值和中位数以及与出生体重的相关性。
第一天Ao直径为6.1（±0.6）mm，第三天为6.2（±0.6）mm；第一天IVC直径为2.5（±0.5），第三天为2.61（±0.5）。IVC/Ao直径指数在第1天为0.4（±0.1），第3天为0.4（±0.1）。我们发现其与出生体重呈正相关。我们发现小于胎龄儿（SGA）和大于胎龄儿（LGA）新生儿的指数存在显著差异（0.36对0.47）。尽管新生儿从第一天到第三天体重显著下降，但我们确定这对IVC、Ao的直径及IVC/Ao指数没有影响。
我们确定了IVC和Ao直径以及IVC/Ao指数的正常值。我们认为，利用该指数评估血管内容量是可行的。SGA新生儿的结果凸显了该指数的重要性。需要更多研究来了解SGA病理生理学的一些要点。
