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新生儿科医生与儿科心脏病专家对早产儿动脉导管未闭进行超声心动图检查的比较

Neonatologist-Performed Echocardiography versus Pediatric Cardiologist for the Patent Ductus Arteriosus in Preterm Newborns.

作者信息

Beyazal Meryem, Hosagasi Nihan Hilal, Torun Emine Gulsah, Bagrul Denizhan, Kurt Abdullah

机构信息

Department of Pediatric Cardiology, Ankara Bilkent City Hospital, Children Hospital, Ankara, Türkiye.

Department of Neonatology, Ankara Bilkent City Hospital, Children Hospital, Ankara, Türkiye.

出版信息

Turk Arch Pediatr. 2025 May 2;60(3):274-279. doi: 10.5152/TurkArchPediatr.2025.24260.

Abstract

Objective: Premature babies have a fragile circulatory system balance; therefore, rapid inter- vention may be needed in patients with patent ductus arteriosus (PDA). Echocardiography performed by a neonatologist can help to choose the best treatment option for newborns in a timely manner. The aim is to evaluate the performance of neonatologists in ductus assessment. Materials and Methods: Among the neonates born at the hospital, those diagnosed with PDA (n=40) under 32 weeks of gestational age were evaluated with echocardiography by a neo- natologist and a pediatric cardiologist. Interobserver variability analysis was done using the intraclass coefficient value and Cohen's kappa test results. Results: An excellent interobserver agreement was found in the peak systolic-to-end diastolic flow velocity ratio, a good agreement in the narrowest diameter of the ductus, peak systolic and diastolic velocities, and mitral A velocity. Raters had moderate to poor agreement in the rest of the variables such as left atrium/aorta ratio, ampulla diameter, length of the ductus, and left pulmonary artery diameter. Conclusion: It is suggested that neonatologists perform echocardiography to measure the nar- rowest diameter of the ductus and ductal flow velocities for PDA evaluation.

摘要

目的

早产儿的循环系统平衡较为脆弱;因此,动脉导管未闭(PDA)患者可能需要迅速干预。新生儿科医生进行的超声心动图检查有助于及时为新生儿选择最佳治疗方案。目的是评估新生儿科医生在导管评估方面的表现。材料与方法:在该医院出生的新生儿中,对那些胎龄小于32周且被诊断为PDA(n = 40)的新生儿,由一名新生儿科医生和一名儿科心脏病专家进行超声心动图评估。使用组内相关系数值和科恩kappa检验结果进行观察者间变异性分析。结果:在收缩期峰值与舒张期末期流速比值方面发现观察者间一致性极佳,在导管最窄直径、收缩期和舒张期峰值流速以及二尖瓣A峰流速方面一致性良好。评估者在其余变量如左心房/主动脉比值、壶腹直径、导管长度和左肺动脉直径等方面的一致性为中等至较差。结论:建议新生儿科医生进行超声心动图检查以测量导管最窄直径和导管流速,用于评估PDA。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7e1/12093403/7cec8fbd63e5/tap-60-3-274_f001.jpg

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