应用全方向M型超声心动图评价二尖瓣置换术患者术中右心功能

发布时间：2018-06-01 00:11

本文选题：超声心动图 + 二尖瓣置换术　；参考：《福建医科大学》2014年硕士论文

【摘要】：目的 1.探讨全方向M型超声心动图评价二尖瓣置换术中患者右心功能的应用价值。 2.分析全方向M型超声心动图与其他超声定量技术的相关性。方法 1.研究对象:对照组30例，单纯二尖瓣狭窄行二尖瓣置换术的患者58例。 2.仪器:LEJ-2型全方向M型超声心动图系统，GE Vivid-7Dimension彩色超声心动图诊断仪配有Echo PAC工作站。 3.方法:(1)应用经食道超声心动图采集所有患者术前、术后连续3个心动周期系列切面图像。分别应用定量组织速度成像技术（quantitative tissue velocityimaging，QTVI）及LEJ-2型全方向M型超声心动图（Omni-directional M-modeechocardiography，，OME）测量三尖瓣环收缩期峰值速度（Sa）；应用二维超声斑点追踪成像技术（two dimension speckle-tracking imaging，2D-STI）测量所有研究对象右室心肌收缩期纵向峰值应变（S）；分别应用OME及解剖M型超声心动图（anatomic M-mode echocardiography，AMM）测量对照组左室短轴切面乳头肌水平各壁收缩期峰值速度。(2)比较术后三尖瓣环收缩期峰值速度较术前变化情况，并分析Sa与肺动脉收缩压（pulmonary arterial systolicpressure，PASP）的相互关系。分析OME与QTVI测值之间、OME与2D-STI测值之间及OME与AMM测值之间的相关性。结果 1.术后三尖瓣环大部分位点收缩期峰值速度较术前增加（P0.01）。 2.三尖瓣环收缩期峰值速度与PASP成负相关（r=-0.85, P0.01）。 3. OME与QTVI技术测值比较差异无统计学意义（P0.05），相关分析显示相关性良好（r=0.94，P0.01）。OME与2D-STI技术测值相关分析显示相关性良好（r=0.95，P0.01）。OME与AMM技术测量左室乳头肌水平各壁收缩期峰值速度差异无统计学意义（P0.05），相关分析显示相关性良好（r=0.81，P0.01）。结论全方向M型超声心动图能够准确、实时、即刻评价右室心肌各个运动方向的综合作用力，较快地反映二尖瓣置换术患者的右心功能。为心脏外科医生及麻醉师提供有用的依据。在术中监测评价二尖瓣置换术患者术中右心功能具有一定价值。
[Abstract]:Purpose

1 . To evaluate the application value of omni - directional M - mode echocardiography in evaluating the right ventricular function in patients with mitral valve replacement .

2 . To analyze the correlation between omni - directional M - mode echocardiography and other ultrasonic quantitative techniques .

2 . Instrument : LEJ - 2 All - directional M - mode Echocardiogram System , with Echo PAC workstation equipped with GE - 7Dimension color echocardiography diagnostic instrument .

1 . Subjects : 30 patients in the control group and 58 patients with mitral valve replacement alone .

method

Methods : ( 1 ) The peak velocity of tricuspid annular systolic phase ( Sa ) was measured by quantitative tissue velocity imaging ( QTVI ) and LEJ - 2 omni - directional M - mode echocardiography ( OME ) .
Two - dimension ultrasonic - tracking imaging ( 2D - STI ) was used to measure the longitudinal peak strain ( S ) of the right ventricular myocardium in all subjects .
The peak velocity of each wall was measured by OME and anatomic M - mode echocardiography ( AMM ) . ( 2 ) The correlation between the peak velocity of tricuspid annular contraction and pulmonary arterial pressure ( PASP ) was compared between OME and QTVI , and between OME and 2D - STI measured values and between OME and AMM values .

Results

1 . The peak systolic velocity of tricuspid ring was increased before operation ( P0.01 ) .

2 . The peak velocity of tricuspid annuloplasty was negatively correlated with PASP ( r = - 0.85 , P0.01 ) .

3 . There was no significant difference between OME and QTVI ( P0.05 ) , and the correlation was good ( r = 0.94 , P0.01 ) . Correlation analysis showed good correlation between OME and 2D - STI measurements ( r = 0.95 , P0.01 ) . There was no significant difference in peak systolic velocity between OME and AMM ( P0.05 ) , and the correlation was good ( r = 0.81 , P0.01 ) .

Conclusion

All - directional M - mode echocardiography was able to evaluate the right ventricular function accurately and in real time . It can reflect the right ventricular function of the patients with mitral valve replacement . It is useful for cardiac surgeons and anesthesiologists . In the intraoperative monitoring , the right ventricular function in patients undergoing mitral valve replacement is of certain value .
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R540.45;R654.2

【参考文献】