12岁以上青少年及成年人Ebstein畸形手术前后的超声心动图评估

发布时间：2018-05-07 17:18

本文选题：超声心动图 + Ebstein畸形　；参考：《中国超声医学杂志》2015年06期

【摘要】：目的应用超声心动图评价12岁以上青少年及成年人Ebstein畸形外科手术疗效。方法 58例12岁以上青少年及成年人Ebstein畸形患者在术前及术后2周内分别进行超声心动图检查,分别测量左、右心室前后径、三尖瓣环大小、三尖瓣前向流速、三尖瓣反流分级。结果 58例Ebstein畸形患者中,术前隔叶下移57例,后叶下移58例,隔叶缺如1例,前叶下移1例,其余三尖瓣前叶均无下移,但发育冗长,房化右室形成,所有病例均有右房扩大、三尖瓣瓣环扩张及三尖瓣反流,以3~5级为主。2例Glenn手术,2例人工瓣置换。54例成功进行三尖瓣成形,术后超声心动图显示三尖瓣环缩小,瓣膜反流明显减少,以2级及以下为主,右室大小及三尖瓣瓣环大小明显回缩。结论超声心动图可以便捷地评价12岁以上青少年及成年人Ebstein畸形术前及术后三尖瓣结构与功能、右心室大小变化,确定手术疗效。
[Abstract]:Objective to evaluate the surgical effect of Ebstein malformation in adolescents and adults over 12 years old by echocardiography. Methods Echocardiography was performed in 58 patients with Ebstein malformation over 12 years of age before and 2 weeks after operation. The anterior and posterior diameter of left and right ventricle, the size of tricuspid annulus and the anterior flow velocity of tricuspid valve were measured. Tricuspid regurgitation classification. Results among the 58 patients with Ebstein malformation, 57 cases were inferior to the septal lobe, 58 cases to the posterior lobe, 1 case to the absence of the septal lobe, 1 case to the anterior lobe, and 1 case to the anterior lobe of the tricuspid valve. All patients had right atrial enlargement, tricuspid annulus dilatation and tricuspid regurgitation. Tricuspid valvuloplasty was successfully performed in 2 patients with Glenn operation in grade 3 or 5, and tricuspid annulus was constricted by echocardiography after operation. Valvular regurgitation was significantly reduced, mainly in grade 2 and below, and the size of right ventricle and tricuspid annulus was significantly reduced. Conclusion Echocardiography can be used to evaluate the structure and function of tricuspid valve and the changes of right ventricular size before and after Ebstein malformation in adolescents and adults over 12 years of age.
【作者单位】：中国医学科学院北京协和医学院国家心血管病中心阜外心血管病医院超声科心血管疾病国家重点实验室;
【基金】：首都医学发展基金(No.2007-shF05)
【分类号】：R654.2;R540.45

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