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Title:: Echocardiographic study on changes of cardiac hemodynamics and load after ventricular septal defects occlusion

作者:: 石晶¹; 3; 张军¹; 李军¹; 李利¹; 左健²; 第四军医大学西京医院：1.超声诊断科， 2．心脏外科,陕西西安 710032;3.兰州军区临潼疗养院第二疗区特诊科，陕西西安 710600

Author(s):: SHI Jing¹; 3; ZHANG Jun¹; LI Jun¹; LI Li¹; ZUO Jian²; 1.Department of Ultrasonic Diagnosis, 2.Department of Cardiac Surgery, Xijing Hospital, Fourth Military Medical University, Xi′an 710032, Shaanxi, China;3.Department of Special Diagnosis, PLA Lintong Sanatorium, Lanzhou Military Area Command, Xi′an 710600, Shaanxi, China

关键词:: 超声心动图; 室间隔缺损; 封堵

Keywords:: echocardiography; ventricular septal defect; occlusion

分类号:: R541.1; R540.45

DOI:: -

文献标识码:: A

摘要:: 目的应用经胸超声心动图(TTE)评价室间隔缺损(VSD)封堵术前、后心脏血流动力学和负荷的变化。方法西京医院VSD封堵术患者46（女32，男14）例，年龄2～45（11±11）岁。于封堵术前、术后3 d、3个月及6个月行TTE检查。测量肺动脉瓣口、二尖瓣口血流速度，左、右心室和心房大小的变化。结果 VSD封堵术后3 d、3个月、6个月肺动脉瓣口最大流速、平均流速、速度时间积分以及二尖瓣口E峰和A峰值血流速度较术前显著降低(P<0.01)；左心房、左心室各径较术前显著减小(P<0.05,P<0.01)；右室舒张末期横径较术前显著减小（P<0.05）；肺动脉中段内径较术前显著减小（P<0.01）。结论 VSD封堵治疗后改变了患者血流动力学异常，使心腔前负荷变化得以纠正。TTE在VSD封堵术后的疗效观察中具有重要的作用。

Abstract:: AIM To evaluate the changes of cardiac hemodynamics and load before and after ventricular septal defect (VSD) occlusion by transthoracic echocardiography (TTE). METHODS TTE was performed in 46 VSD patients ［female 32, male 14, aged from 2～45 (11±11) years］ before and three days, three months and six months after occlusion. The velocity of pulmonary artery and mitral valve and the size of left ventricle and atrium as well as right ventricle and atrium were measured. RESULTS Three days, three months and six months after VSD occlusion, the maximal velocity, mean velocity and velocitytime integral of pulmonary artery, and E peak and A peak velocity of mitral valve significantly reduced (P<0.01). The diameters of left atrium and ventricle (P<0.05,P<0.01), the transverse diameter of right ventricle in diastolic end (P<0.05) and the middle part diameter of pulmonary artery also markedly decreased (P<0.01). CONCLUSION The abnormal hemodynamics and preload changes of cardiac chamber of VSD patient are corrected after VSD occlusion. TTE is a valuable method to observe the therapeutic effect of VSD occlusion.

参考文献/References

［1］ Hijazi AM, Hakim F, Haweleh AA, et al. Catheter closure of perimenbranous ventricular septal defect using the new Amplatzer membranous VSD occluder: initial clinical experience ［J］. Catheter Cardiovasc Interv, 2002,56(4):508-515.

［2］ Bass JL, Kalra GS, Arora R, et al. Initial humam experience with the Amplatzer perimembranous ventricular septal occluder device［J］. Catheter Cardiovasc Interv, 2003,58(2):238-245.

［3］张军，李军，石晶，等. 超声心动图在嵴内型房间隔缺损封堵中的作用［J］. 心脏杂志,2005,17(3):275-278.

［4］李军，张军，段云燕,等. 超声心动图与心血管造影在室缺封堵术中的互补价值［J］. 中国超声医学杂志, 2005,21(6):433-435.

［5］张华，邵东龙，孙万峰，等. 经胸彩色多普勒超声心动图在室间隔缺损封堵术中的研究［J］. 中国临床医学影像杂志,2004,15(11):656-657.

［6］王凡，汤宝鹏，马依彤，等. 应用Amplatzer封堵器介入治疗膜部室缺远期疗效评价［J］. 新疆医科大学学报,2004,27(3):237-239.

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超声心动图对室间隔缺损封堵术心脏血流动力学及其负荷的变化观测(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

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