单侧肺动脉起源于升主动脉的超声诊断与预后

发布时间：2018-05-21 12:29

本文选题：单侧肺动脉起源异常 + 超声心动描记术　；参考：《中国医学影像技术》2015年04期

【摘要】：目的探讨单侧肺动脉异常起源于升主动脉(AOPA)的早期超声诊断及预后评估。方法回顾性分析12例经手术确诊的AOPA患儿的影像学资料、治疗及随访情况。结果 12例患者均为右肺动脉起源于升主动脉(AORPA),均合并其他心脏畸形,其中以合并动脉导管未闭最多见(8/12,66.67%)。术前超声心动图确诊10例,诊断符合率83.33%(10/12)。术前超声心动图证实肺动脉高压者11例(11/12,93.67%),平均肺动脉压(79.45±14.36)mmHg术后1周平均肺动脉压(35.91±16.26)mmHg,手术前后平均肺动脉压差异有统计学意义(Z=3.936,P=0.003);术前9例重度肺动脉高压者中,术后正常5例,中度3例,轻度1例;术前2例中度者中,术后正常1例,轻度1例。无肺动脉高压的1例患儿合并法洛四联症。术后成功随访8例,随访时间1~50个月,肺动脉压力均恢复正常。随访期间无再次手术病例。结论在AOPA的临床诊断中,超声心动图如联合多层螺旋CT心血管CTA检查,可能替代心导管造影这一有创性检查。早期诊断并治疗AOPA,预后良好。
[Abstract]:Objective to investigate the early ultrasonographic diagnosis and prognosis of unilateral pulmonary artery abnormalities originating from ascending aortic aneurysm (AOPA). Methods the imaging data, treatment and follow-up of 12 patients with AOPA were retrospectively analyzed. Results all the 12 patients had right pulmonary artery originated from AORPAN of ascending aorta, and all of them were complicated with other cardiac malformations. Among them, 8 / 1266.67m was most common in patients with patent ductus arteriosus (patent ductus arteriosus). 10 cases were diagnosed by echocardiography before operation, the diagnostic coincidence rate was 83.33% and 10 / 12%. Before operation, 11 cases of pulmonary hypertension were confirmed by echocardiography. The mean pulmonary artery pressure was 35.91 卤16.26 mm Hg in one week after operation, and the mean pulmonary artery pressure was 35.91 卤16.26 mm Hg in 1 week after operation. There was significant difference in mean pulmonary artery pressure before and after operation in 9 patients with severe pulmonary hypertension before and after operation, 5 patients with severe pulmonary hypertension before operation, 5 patients with normal pulmonary hypertension after operation. 3 cases were moderate, 1 case was mild, 2 cases were moderate before operation, 1 case was normal after operation, 1 case was mild. There was no pulmonary hypertension in one child with tetralogy of Fallot. 8 cases were followed up successfully for 1 ~ 50 months. Pulmonary artery pressure returned to normal. There were no cases of reoperation during the follow-up period. Conclusion in the clinical diagnosis of AOPA, echocardiography combined with multislice spiral CT cardiovascular CTA may replace the invasive examination of cardiac catheterization. Early diagnosis and treatment of AOPA have a good prognosis.
【作者单位】：重庆医科大学附属儿童医院心血管内科;重庆医科大学附属儿童医院放射科;
【分类号】：R445.1;R543.2

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