B-TDE在ICU评价心脏瓣膜置换术后PASP的准确性研究
发布时间：2018-08-14 16:53
【摘要】：目的评价床边经胸多普勒超声心动图（bedside transthoracic dopplerechocardiography，B-TDE）在重症监护室（intensive care unit，ICU）对心脏瓣膜置换术后患者估测肺动脉收缩压（pulmonary artery systolic pressure，PASP）的准确性。 方法72例心脏瓣膜置换术后患者，术前放置右心导管，术后48小时内在ICU同时接受B-TDE和右心导管两种方法对PASP测量。将两种方法所测得PASP结果差异进行分析。 结果在72例受试对象中，其中主动脉瓣置换术后12例，二尖瓣置换术后38例，双瓣置换术后22例；右房（四腔心切面）前后径50mm者28例。两种方法所得PASP按主动脉瓣置换术后（A组）、二尖瓣置换术后（B组）及双瓣置换术后（C组）分组进行t检验，A组B-TDE (35±12)mmHg VS右心导管(36±16)mmHg，P=0.765，B组B-TDE (38±13)mmHg VS右心导管(36±14)mmHg，P=0.705，C组B-TDE(38±14)mmHg VS右心导管(40±12)mmHg，P=0.685，两种方法在A、B、C三组中测定PASP结果差异均无统计学意义(1mmHg=0.133kPa)。 分别对右房（四腔心切面）前后径50mm者与右房（四腔心切面）前后径50mm者两种方法所得PASP进行t检验，右房（四腔心切面）前后径50mm者B-TDE(38±11)mmHg VS右心导管(38±12)mmHg，P=0.852，右房（四腔心切面）前后径50mm者B-TDE(37±14)mmHg VS右心导管(37±14)mmHg，P=0.474，对于不同的右房大小患者两种方法测定PASP结果差异无统计学意义。Pearson相关分析显示B-TDE与右心导管测量的PASP呈中度相关，A组r=0．64，P0．05，B组r=0．68，P0．05，C组r=0．61，P0．05。BTDE与右心导管测量PASP差值在10mm Hg以上者31例(43.0％)，其中BTDE低于右心导管测量者22例(30.5％)，高于右心导管测量者9例(12.5％)。 结论心脏瓣膜置换术后患者在ICU经B-TDE测量PASP与右心导管法测定的PASP差异性均无统计学意义，两种方法在所有受试患者中测定的PASP呈中度相关。B-TDE在ICU对于心脏瓣膜置换术后患者可快速提供可靠的PASP资料。
[Abstract]:Objective to evaluate the accuracy of (bedside transthoracic Doppler echocardiography B-TDE in estimating pulmonary arterial systolic pressure (pulmonary artery systolic) after cardiac valve replacement in (intensive care unit of intensive care unit (ICU). Methods right cardiac catheters were placed in 72 patients after cardiac valve replacement. Both B-TDE and right cardiac catheterization were used to measure PASP in ICU within 48 hours after operation. The differences between the PASP results obtained by the two methods were analyzed. Results there were 12 cases after aortic valve replacement, 38 cases after mitral valve replacement, 22 cases after double valve replacement, and 28 cases with right atrium (four-chamber view) anterior diameter 50mm. PASP obtained from two methods were divided into three groups: after aortic valve replacement (group A), after mitral valve replacement (group B) and after double valve replacement (group C). T test was performed in group A (35 卤12) mmHg VS), right cardiac catheterization (36 卤16) mm, B-TDE (B-TDE) (38 卤13) mmHg VS), right ventricular catheterization (36 卤14) mm, right cardiac catheterization 0.705 B-TDE (38 卤14) mmHg VS). There was no significant difference (1mmHg=0.133kPa) between the two methods in the determination of PASP in the three groups. T test was performed on the PASP obtained by the two methods: the right atrium (four-chamber section) anterior diameter 50mm and the right atrium (four-chamber central section) anteroposterior diameter 50mm. B-TDE (38 卤11) mmHg VS) and 50mm (37 卤14) mmHg VS) with anterior and posterior diameter of right atrium (50mm) were found in B-TDE (38 卤11) mmHg VS) and B-TDE (37 卤14) mmHg VS), respectively. There was no significant difference in PASP results between the two methods in patients with different right atrial sizes. The results of PASP in patients with right atrium diameter were (38 卤12) mm, (38 卤12) mm, and (0.852) mm, respectively, while those with 50mm were (37 卤14) mmHg VS, (37 卤14) mm, respectively. There was no significant difference between the two methods in detecting PASP in patients with different right atrial sizes. Pearson correlation analysis showed that there was a moderate correlation between B-TDE and PASP measured by right cardiac catheterization in 31 cases (43.0%) whose PASP difference between right cardiac catheterization and B-TDE was above 10mm Hg, and BTDE was lower than that of right cardiac conduction in group A (n = 0.68) and group C (n = 0.05). 22 cases (30.5%) were measured by tube, which was higher than that of 9 cases (12.5%) by right cardiac catheterization. Conclusion there was no significant difference in PASP between PASP and right cardiac catheterization in ICU after cardiac valve replacement. The PASP measured by both methods in all subjects showed moderate correlation. B-TDE could provide reliable PASP data for patients after cardiac valve replacement with ICU.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R654.2;R540.45
本文编号：2183506
[Abstract]:Objective to evaluate the accuracy of (bedside transthoracic Doppler echocardiography B-TDE in estimating pulmonary arterial systolic pressure (pulmonary artery systolic) after cardiac valve replacement in (intensive care unit of intensive care unit (ICU). Methods right cardiac catheters were placed in 72 patients after cardiac valve replacement. Both B-TDE and right cardiac catheterization were used to measure PASP in ICU within 48 hours after operation. The differences between the PASP results obtained by the two methods were analyzed. Results there were 12 cases after aortic valve replacement, 38 cases after mitral valve replacement, 22 cases after double valve replacement, and 28 cases with right atrium (four-chamber view) anterior diameter 50mm. PASP obtained from two methods were divided into three groups: after aortic valve replacement (group A), after mitral valve replacement (group B) and after double valve replacement (group C). T test was performed in group A (35 卤12) mmHg VS), right cardiac catheterization (36 卤16) mm, B-TDE (B-TDE) (38 卤13) mmHg VS), right ventricular catheterization (36 卤14) mm, right cardiac catheterization 0.705 B-TDE (38 卤14) mmHg VS). There was no significant difference (1mmHg=0.133kPa) between the two methods in the determination of PASP in the three groups. T test was performed on the PASP obtained by the two methods: the right atrium (four-chamber section) anterior diameter 50mm and the right atrium (four-chamber central section) anteroposterior diameter 50mm. B-TDE (38 卤11) mmHg VS) and 50mm (37 卤14) mmHg VS) with anterior and posterior diameter of right atrium (50mm) were found in B-TDE (38 卤11) mmHg VS) and B-TDE (37 卤14) mmHg VS), respectively. There was no significant difference in PASP results between the two methods in patients with different right atrial sizes. The results of PASP in patients with right atrium diameter were (38 卤12) mm, (38 卤12) mm, and (0.852) mm, respectively, while those with 50mm were (37 卤14) mmHg VS, (37 卤14) mm, respectively. There was no significant difference between the two methods in detecting PASP in patients with different right atrial sizes. Pearson correlation analysis showed that there was a moderate correlation between B-TDE and PASP measured by right cardiac catheterization in 31 cases (43.0%) whose PASP difference between right cardiac catheterization and B-TDE was above 10mm Hg, and BTDE was lower than that of right cardiac conduction in group A (n = 0.68) and group C (n = 0.05). 22 cases (30.5%) were measured by tube, which was higher than that of 9 cases (12.5%) by right cardiac catheterization. Conclusion there was no significant difference in PASP between PASP and right cardiac catheterization in ICU after cardiac valve replacement. The PASP measured by both methods in all subjects showed moderate correlation. B-TDE could provide reliable PASP data for patients after cardiac valve replacement with ICU.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R654.2;R540.45
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