超声心动图在婴幼儿室间隔完整型肺动脉闭锁术前诊断中的临床价值

发布时间：2018-06-19 12:39

本文选题：超声心动描计术 + 室间隔完整型肺动脉闭锁　；参考：《南京医科大学学报(自然科学版)》2015年08期

【摘要】：目的:探讨室间隔完整型肺动脉闭锁(pulmonary atresia with intact ventricular septum,PA-IVS)超声心动图的诊断要点及其与临床手术的相关性。方法:回顾性分析经超声诊断、手术证实的30例PA-IVS患儿的超声心动图特征,通过估测三尖瓣Z值评价右室发育情况用以指导手术。结果:30例患儿均经过超声心动图诊断后及时进行手术干预,有28例在术前超声心动图检查中得到确诊,另外2例虽图像质量不佳,但结合彩色及连续多普勒超声仍高度怀疑PA-IVS。结论:超声心动图在病程早期可及时对PA-IVS做出可靠诊断,同时评价右室发育情况用以指导手术,在术前探查中应着重注意观察肺动脉闭锁的水平、右室及三尖瓣发育状况、合并其他心内畸形、右室-冠状动脉交通以及预测是否存在右室依赖的冠状动脉循环等,有助于快速、有效地指导临床手术患儿的筛选以及手术方式的选择。
[Abstract]:Objective: to investigate the diagnostic features of pulmonary atresia with intact ventricular septum (PA-IVS) echocardiography and its correlation with clinical operation. Methods: the echocardiographic features of 30 children with PA-IVS confirmed by operation were analyzed retrospectively. The right ventricular development was evaluated by estimating the Z value of tricuspid valve. Results all the 30 cases underwent early intervention after echocardiography diagnosis, 28 cases were diagnosed by echocardiography before operation, the other 2 cases were still highly suspicious of PA-IVS in combination with color and continuous Doppler ultrasound, although the image quality was not good. Conclusion: echocardiography can make reliable diagnosis of PA-IVS in the early stage of the disease, and evaluate the development of right ventricle to guide the operation. The level of pulmonary atresia, the development of right ventricle and tricuspid valve should be observed during preoperative exploration. The combination of other intracardiac malformations, right ventricular coronary artery communication and prediction of the existence of right ventricular dependent coronary artery circulation are helpful to guide the selection of clinical children and the choice of operation methods quickly and effectively.
【作者单位】：南京医科大学附属南京儿童医院超声诊断科;南京医科大学附属南京儿童医院心胸外科;
【基金】：南京医科大学科技发展基金面上项目(2012NJMU055)
【分类号】：R540.45;R725.4

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