经颅多普勒超声评估袋鼠式护理对早产儿大脑中动脉脑血流动力学的影响。
Effect of Kangaroo Mother Care on Cerebral Hemodynamics in Preterm Neonates Assessed by Transcranial Doppler Sonography in Middle Cerebral Artery.
机构信息
Department of Neonatology, Pramukhswami Medical College, Bhaikaka University, Karamsad, Gujarat.
Department of Neonatology, Pramukhswami Medical College, Bhaikaka University, Karamsad, Gujarat and Central Research Services, Charutar Arogya Mandal, Bhaikaka University, Karamsad, Gujarat. Correspondence to: Dr Somashekhar M Nimbalkar, Professor and Head, Department of Neonatology, Pramukhswami Medical College, Bhaikaka University, Karamsad, Gujarat.
出版信息
Indian Pediatr. 2023 Jan 15;60(1):27-32. doi: 10.1007/s13312-023-2690-y. Epub 2022 Oct 29.
OBJECTIVE
To study the effect of KMC in premature newborns on cerebral hemodynamics in the middle cerebral artery (MCA) using transcranial doppler sonography.
METHODS
In this descriptive study, 40 clinically stable preterm neonates admitted to the neonatal intensive care unit of our institute and undergoing Kangaroo mother care (KMC) were enrolled. Physiological and cerebral blood flow parameters of MCA were obtained by using transcranial doppler sonography at baseline, at 60 minutes of KMC, and after 60 minutes of stopping KMC.
RESULTS
Of the 40 enrolled neonates (24 males), the mean (SD) birth weight, gestation age, and postnatal age were 1698.25 (495.44) g, 33.00 (1.67) wk, and 6.80 (4.51) days, respectively. The mean (SD) cerebral blood flow velocities increased (peak systolic velocity (PSV), P=0.03; end diastolic velocity, P<0.001; mean velocity, P<0.001) and doppler indices decreased (resis-tive index, P=0.001; pulsatility index, P<0.001) significantly; whereas, heart rate (P<0.001) decreased but SpO2 (P=0.001) and mean blood pressure (P=0.003) increased significantly at 60 minutes of KMC as compared to baseline. Sixty minutes after stopping KMC, all parameters (except PSV) were higher than baseline, indicating post KMC effect.
CONCLUSION
KMC improves cerebral hemodynamics in clinically stable preterm neonates.
目的
使用经颅多普勒超声研究袋鼠式护理（KMC）对早产儿大脑中动脉（MCA）脑血流动力学的影响。
方法
在这项描述性研究中，共纳入了我院新生儿重症监护病房中 40 例接受 KMC 的临床稳定早产儿。使用经颅多普勒超声在基线、KMC 开始后 60 分钟和停止 KMC 后 60 分钟分别获取生理和 MCA 脑血流动力学参数。
结果
40 名入组新生儿（男 24 例）的平均（标准差）出生体重、胎龄和生后年龄分别为 1698.25（495.44）g、33.00（1.67）周和 6.80（4.51）天。脑血流速度的平均值（标准差）增加（收缩期峰值速度（PSV），P=0.03；舒张末期速度，P<0.001；平均速度，P<0.001），多普勒指数降低（阻力指数，P=0.001；搏动指数，P<0.001）；而 KMC 开始后 60 分钟时心率（P<0.001）降低，但 SpO2（P=0.001）和平均血压（P=0.003）升高，与基线相比均有显著差异。停止 KMC 后 60 分钟，除 PSV 外，所有参数均高于基线，表明存在 KMC 后效应。
结论
KMC 可改善临床稳定早产儿的脑血流动力学。
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