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房间隔缺损介入治疗中超声测量房缺最大径与球囊伸展径的相关研究(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2002年第2期
页码:
154-156
栏目:
临床研究
出版日期:
2002-03-01

文章信息/Info

Title:
Correlative study between the largest ASD diameter measured byechocardiography and balloon stretched diameter
作者:
张玉顺1;  张　军2;  吴栋良1;  代正学11;  李　寰1;  刘建平31;  贾国良1
第四军医大学西京医院: 1. 心血管内科, 2. 超声科, 3. 小儿科, 陕西 西安 710032
Author(s):
ZHANG Yu-shun11;  ZHANG Jun2; WU Dong-liang1;  DAI Zheng-xue1;  LI Huan1;  LIU Jian-ping1;  JIA Guo-liang1
Cardiology Department of Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi 710032, China
关键词:
房间隔缺损;  介入治疗;  超声心动描记术
Keywords:
Atrial septal defect ;  Transcatheter closure ;  Echocardiography
分类号:
-
DOI:
-
文献标识码:
A
摘要:
目的 分析房间隔缺损(ASD) 直径的经胸超声心动图(TTE) 和经食管超声心动图(TEE) 测量的最大径与球囊导管测量的ASD 伸展直径(BSD) 的关系, 探讨在ASD 介入治疗中用超声心动图测量ASD 最大值替代BSD 的可能性。方法 全组共54 例, 年龄7. 0～ 65 (30士19) 岁。按照ASD 边缘状况的不同分为硬缘组(A组):38 例, 超声显示房缺周缘较长、较硬者或(和) 边缘为硬缘和极软缘组成, 而剔除极软缘者; 软缘组(B 组):16例, 超声显示房缺缘较软或甚软但较长者。结果 ① TTE 和TEE 测量ASD 的最大径之间无显著差异, 但均明显小于ASD 的BSD (P<0.01) ; ②TTE 和TEE 测量A SD 的最大径与BSD 显著相关( r= 0.86, 0.83, P<0. 01)。③A 组TTE 和TEE 测量ASD 的最大径与BSD 非常接近, 相关程度更好; ④B 组超声房缺测值往往明显小于BSD, 相关较低。结论 ASD 直径的球囊测量值仍应作为选择封堵器的“金标准”。对于房缺周缘为硬缘者, TTE 能较准确地独立估测A SD 直径并可代替球囊测量; 对于房缺周缘为软缘者, 则仍需应用球囊测量。
Abstract:
AIM To investigate the feasibility of the largest ASD diameter measured by echocardiography instead of balloon stretched diameter(BSD) of ASD in transcatheter interventions to analyze the relation of ASD diameter measured by transthoracic and transesophageal echocardiography(TTE and TEE) to BSD.METHODS There were 40 patients with the age of 30±19years (ranging from 7 to 65 years). The patients were divided into 2 groups according to ASD edge. In group A(n=38), ASD with solid edge or/and ASD with very soft and floppy edge attached to solid basement and only the solid basement be measured with TTE and TEE. In group B (n=16) , ASD with soft and floppy edge be measured with TTE and TEE.RESULTS There was no significant difference between the largest ASD diameter sizes measured by TTE and TEE(P>0.05) . The largest ASD diameter sizes of ASDs measured with TTE and TEE were much smaller than BSD (P<0.01). A good correlation was found between the TTE or TEF and BSD(r=0.83 for TTE and BSD,r=0.86 for TEE and BSD,P<0.01) in measurement of ASD size.The largest ASD diameter sizes of ASDs measured with TTE and TEE were similar to BSD in group A. But the largest ASD diameter sizes of ASDs were smaller significantly than BSD in group B (P<0.01).CONCLUSION: The balloon stretched diameter still should be“golden standard”of selecting the diameter of occluder. TEE can be used to select the patients suitable for transcatheter interventions independently in the following conditions:①ASD with solid edge;②ASD with very soft and floppy edge attached to solid basement and only the solid basement be measured with TEE. However, BSD should be measured in ASD with soft and floppy edge.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2001-10-23.
更新日期/Last Update: 2002-03-01