长期以来，新生儿（尤其是早产儿）循环功能的临床评估存在局限性，这一问题推动新生儿科医师在过去10年愈发依赖床旁超声心动图技术，以评估患儿的心脏功能与血流动力学状态［1］。在全球范围内，越来越多的新生儿重症监护室（neonatal intensive care units, NICU）已正式建立，并将超声心动图纳入危重新生儿的诊断和管理［2-3］。
本文中术语“目标性新生儿超声心动图（targeted neonatal echocardiography, TNE）”，是由美国超声心动图学会（American Society of Echocardiography）专家组于2011年提出［4］。2024年，美国超声心动图学会发布了《新生儿重症监护室中目标性新生儿超声心动图和心脏监护床旁超声的指南和建议：美国超声心动图学会的最新进展》［5］，该指南聚焦心脏结构基本正常但存在血流动力学紊乱的新生儿群体，由经过专项训练的新生儿科专家全程主导——负责操作、过程监督及结果解读，实现对新生儿心脏功能与血流动力学状态的全面评估。NICU的心脏床旁超声（cardiac point-of-care ultrasound, cPOCUS）尚未明确定义［6］，通常是指对心脏功能、留置导管和致命性心包积液的简短定性评估［7］。本解读的主要目的是深度拆解该指南的核心框架与实践要点，为国内新生儿重症医学领域提供可落地的技术参考与临床决策依据，助力提升我国NICU对该类特殊新生儿心脏功能及血流动力学的精准评估能力，优化诊疗路径与预后效果。
等容舒张期（isovolumetric relaxation time, IVRT）由心房腔室间的压力梯度决定，用于估算左心房压力克服左心室压力、开启二尖瓣并启动充盈的时间（表3）。IVRT缩短提示左房压力增高（如具有血流动力学意义的PDA），或左室弹性增强，反之亦然。容量负荷（如具有血流动力学意义的PDA）或压力负荷（如左心室舒张末期压升高）可通过左房与主动脉根部尺寸的比值来量化（表3）。
PVR可辅助判断PAP升高是否与肺血管疾病相关。肺动脉加速时间（pulmonary artery acceleration time, PAAT）与右心室射血时间（right ventricle ejection time, RVET）的关系可作为PVR的替代指标（PVR指数，表6）。PAAT/RVET<0.25时（或RVET/PAAT>4.0），提示PVR可能升高［24］。
Guidelines and recommendations for targeted neonatal echocardiography and cardiac point-of-care ultrasound in the neonatal intensive care unit: an update from the American Society of Echocardiography
International evidence-based guidelines on point of care ultrasound (POCUS) for critically ill neonates and children issued by the POCUS Working Group of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC)
Randomised controlled clinical trial of standard versus echocardiographically guided ibuprofen treatment for patent ductus arteriosus in preterm infants: a pilot study
A comprehensive echocardiographic protocol for assessing neonatal right ventricular dimensions and function in the transitional period: normative data and Z scores
Systolic right ventricular function in preterm and term neonates: reference values of the tricuspid annular plane systolic excursion (TAPSE) in 258 patients and calculation of Z-score values
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Guidelines and recommendations for targeted neonatal echocardiography and cardiac point-of-care ultrasound in the neonatal intensive care unit: an update from the American Society of Echocardiography
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International evidence-based guidelines on point of care ultrasound (POCUS) for critically ill neonates and children issued by the POCUS Working Group of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC)
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Randomised controlled clinical trial of standard versus echocardiographically guided ibuprofen treatment for patent ductus arteriosus in preterm infants: a pilot study
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A comprehensive echocardiographic protocol for assessing neonatal right ventricular dimensions and function in the transitional period: normative data and Z scores
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Systolic right ventricular function in preterm and term neonates: reference values of the tricuspid annular plane systolic excursion (TAPSE) in 258 patients and calculation of Z-score values
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Impaired right ventricular performance is associated with adverse outcome after hypoxic ischemic encephalopathy
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