應用心臟超音波評估生產方式與新生兒卵圓孔未關閉

Evaluation of Delivery on the Neonatal Patent Foramen Ovale by Echocardiography

柯俊祥(CHUN-HSIANG KO)

指導教授 ： 張振榮

中臺科技大學/健康科學院/醫學影像暨放射科學系暨研究所/碩士(2020年)

摘要

卵圓孔持續未關閉會影響人類成長過程中的健康，為了提早診斷及追蹤作業，本研究使用經胸前心臟超音波檢查研究新生兒卵圓孔未關閉的相關因子。本研究選擇新生兒經胸前超音波檢查是無侵入性、無游離輻射及無副作用的篩檢；提早篩檢可減少因卵圓孔或心房中膈缺損產生的症狀。
本研究共有205位新生兒（男嬰110位，3±2 days），選入之新生兒皆符合嬰兒室收住院標準，於出生後5日內施行篩檢。收集每位新生兒之性別、生產方式、妊娠週數和出生體重資料。以GE Vivid 7心臟超音波，選擇主頻率為10 MHz的10S探頭。以標準2D超音波和彩色都卜勒血流顯像於新生兒的肋下掃描。研究結果顯示生產方式（p＜0.001）及出生體重（p=0.038）對新生兒卵圓孔未關閉有顯著性的影響。
優先建議以吸引式生產之新生兒接受經胸前心臟超音波檢查，其次建議出生體重小於3111±346 gm之新生兒能接受經胸前超音波檢查，提早診斷及有助於患者追蹤作業。

關鍵字

卵圓孔未關閉 ； 真空吸引式生產 ； 經胸前心臟超音波

並列摘要

Patent foramen ovale affects growing human health. For early diagnosis and follow-up, this study used pre-thoracic echocardiography to study factors associated with unclosed foramen ovale in neonates.
Transthoracic echocardiographic examination is non-invasive, non-ionizing radiation and has no side effects. Patent foramen ovale or atrial septal defect can be detected earlier by screening.
In this study, 205 neonates (110 boys, 3 ± 2 days) in the baby room were enrolled and underwent the screening including standard 2D ultrasound and Doppler color flow mapping within 5 days after birth with GE Vivid 7 and 10 MHz 10S probe. Influence factors including gender, gestational age, birth weight and way of delivery including normal spontaneous delivery (NSD), caesarean section (C/S) and vacuum extraction delivery (VED).
The way of delivery (p <0.001) and birth weight (p=0.038) had a significant impact on neonatal patent foramen ovale. Those babies delivered by vacuum extraction delivery (VED) whose PFO were not close (100%, p <0.001), 86% of the babies with gestational age less than 37 weeks whose PFO were not close For increase every 100 gm of birth weight, the patent foramen ovale closed increases by 8.8% the chance.
Transthoracic echocardiography is a safe method for PFO screening in neonates. It is highly recommended for those who received VED. It is also recommended for those whose birth body weight less than 3111±346 gm for these neonates had a higher incidence to have PFO or ASD which may associate with migraine or CVA.

並列關鍵字

patent foramen ovale ； vacuum extraction delivery ； transthoracic echocardiography

參考文獻

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