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超声心动图评价房间隔缺损封堵术心脏血流动力学及其负荷的变化(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2007年第5期
页码:
559-562
栏目:
临床研究
出版日期:
2007-10-01

文章信息/Info

Title:
Echocardiographic evaluation of cardiac hemodynamics and load changes after atrial 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. 解放军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, Xijing Hospital, Fourth Military Medical University, 2.Department of Cardiac Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, Shaanxi, China; 3.Department of Special Diagnosis, PLA Lintong S
关键词:
超声心动图; 房间隔缺损; 封堵
Keywords:
echocardiography;  atrial 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)评价房间隔缺损(ASD)封堵术前、后心脏血流动力学及负荷的变化。方法 西京医院ASD封堵术患者30（女23，男7）例，年龄4.5～63(28±18)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、三尖瓣口血流速度，左、右心室和心房大小变化。结果 ASD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、速度时间积分以及三尖瓣口E峰和A峰值血流速度较术前显著降低(P<0.01)；肺动脉中段内径、右心房和右心室各径较术前显著减小（P<0.01）；左心房、左心室各径较术前增大 (P<0.05，P<0.01)。术后各个时间点比较各指标也有不同程度改善。结论 ASD封堵治疗后患者血流动力学异常和心腔前负荷变化得以纠正。TTE在ASD封堵术后的疗效观察中具有重要的作用。
Abstract:
AIM To evaluate the changes of hemodynamics and cardiac load before and after atrial septal defect (ASD) occlusion by transthoracicechocardiography (TTE). METHODS TTE was performed, before and 3 days, 3 months and 6 months after ASD occlusion, in 30 patients with ASD ［female 23, male 7; aged from 4.5 to 63 (28±18) years］. The velocity of pulmonary artery and tricuspid valve, and the size of left ventricle and atrium as well as right ventricle and atrium were measured. RESULTS Compared with those before ASD occlusion, the maximal velocity, mean velocity and velocitytime integral of pulmonary artery as well as E peak and A peak velocity of tricuspid valve were significantly reduced (P<0.01) and the middle part diameter of pulmonary artery and all diameters of right atrium and ventricle were markedlydecreased (P<0.01). The diameters of left atrium and ventricle were significantly augmented (P<0.05,P<0.01). Improvement of different degree was also observed at 3 days, 3 months and 6 months after ASD occlusion. CONCLUSION The abnormal hemodynamics and preload change of cardiac chamber of patient with ASD are corrected after the treatment of occlusion. TTE is a valuable method to observe the effect of ASD occlusion.

参考文献/References

［1］张军，姚志勇，田英军，等. 二维超声心动图及组织多普勒检测房间隔缺损封堵术前后右心负荷的变化［J］. 心脏杂志,2004,16(1):64-66.

［2］Sideris EB, Leung M, Yooh JH, et al. Occlusion of large atrial septal defects with a centering buttoned device early clinical experience［J］. Am Heart J, 1996,131(2):356-359.

［3］Shigenobu M, Sano S. Surgical indications and treatment of mitral valve disease associated with secundum atrial septal defect with special reference to left ventricular geometry and function［J］. J Cardiovasc Surg(Torino),1994,35(6):469-474.

［4］Schreiber TL, Feigenbaum H, Weyman AE. Effect of atrial septal defect repair on left ventricular geometry and degree of mitral valve prolapse［J］. Circulation, 1980,61(5):888-896.

［5］韩伟，穆玉明，吐尔逊娜依，等. 房间隔缺损Amplazer封堵术后心功能变化［J］. 新疆医学,2004,34(5):1-2.

［6］石晶，张军，周晓东，等. 组织多普勒成像在房间隔缺损封堵术中的应用［J］. 心脏杂志,2005,17(3):279-281.

备注/Memo

备注/Memo:
收稿日期：2007-04-05.通讯作者：张军，教授， 主要从事超声心动图研究Email:zhangjun@fmmu.edu.cn作者简介：石晶，硕士，主治医师Email:shijing@126.com
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