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|本期目录/Table of Contents|

超声心动图在嵴内型室间隔缺损封堵中的作用(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2005年第3期
页码:
275-278
栏目:
介入治疗
出版日期:
2005-05-05

文章信息/Info

Title:
Function of echocardiography on occlusion of intercristal ventricular septal defect
作者:
张军1;  李军1;  石晶1;  李利1;  张玉顺2;  左健3
第四军医大学西京医院： 1. 超声科，2. 心内科，3. 心外科,陕西 西安 710032
Author(s):
ZHANG Jun1;  LI Jun1;  SHI Jing1;  LI Li1; ZHANG Yusun2;  ZUO Jian3
1. Department of Ultrasound, 2.Department of Cardiology, 3.Department of Cardiac Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032,China
关键词:
室间隔缺损; 封堵; 超声心动图
Keywords:
ventricular septal defect;  occlusion;  echocardiography
分类号:
R541.1；R540.45
DOI:
-
文献标识码:
A
摘要:
目的 研究超声心动图在嵴内型室间隔缺损（VSD）封堵中的作用，并与X线左室造影结果比较。方法 入选病例包括嵴内型VSD患者13例。二维超声心动图及彩色多普勒血流图于胸骨旁左室长轴、大血管短轴及心尖五腔观测量缺损大小及其距主动脉右冠瓣、肺动脉瓣及三尖瓣的距离；术中行X线左室造影观测缺损口大小、距主动脉右冠瓣距离。封堵器释放后测量其腰部的直径。结果 二维超声心动图与彩色多普勒血流图除2例部分切面难以判断缺损口大小外，其余病例均显示缺损口大小及距各瓣的距离，大部分病例超声术前测量的缺损口大小与释放后封堵器的腰径相似。X线左室造影5例因造影角度不佳无法显示分流口大小，仅显示右室内存在分流；显示分流口的病例中部分明显小于释放后封堵器腰径。本组病例中1例封堵后出现少量主动脉瓣返流，1例术后出现封堵器移位，并出现残余分流。结论 超声心动图对嵴内型VSD封堵的术前选择优于X线左室造影。适合于嵴内型VSD封堵的患者缺损口不宜大于8 mm，并无主动脉瓣脱垂。如缺损口过大可能出现术后主动脉瓣返流或封堵器移位。
Abstract:
AIM To study the function on occlusion of intercristal ventricular septal defect(VSD) and compare with the result of left ventricular angiography. METHODS Thirteen patients with intercristal VSD were studied by measuring defect size and its distance to aortic, pulmonary and tricuspid valves with echocardiography and measuring defect size and its distance to aortic valve with left ventricular angiography of X ray. After releasing occluder, the size of its waist was measured. RESULTS The defect size and its distance to valves could clearly showed by echocardiography except for those in part views of 2 cases. The defect size measured with echocardiography in the most cases before occlusion was similar with the waist size of released occluder. In 5 cases, the ventricular defect shunt could be seen in right ventricle but shunt orifice could not be showed because of improper angle of angiography, while the shunt orifice in part of cases showed with angiography was much more smaller than the waist size of released occluder. A little aortic regurgitation was found in one case and the displacement of occluder with residual shunt was found in another case after occlusion in this group. CONCLUSION Echocardiography is better than angiography on occlusion selection of intercristal VSD. The VSD size should not be larger than 8 mm usually and without aortic regurgitation for intercristal VSD occlusion. Big intercristal VSD might occur aortic regurgitation and occluder displacement after occlusion.

参考文献/References

［1］ 张玉顺，代政学，贾国良，等. 国产双盘封堵器经导管治疗膜部室间隔缺损疗效的初步评价［J］. 心脏杂志，2002，14（6）：518－520.

［2］ 胡海波，蒋世良，徐忠英，等. 经导管室间隔缺损封堵术与外科手术治疗膜周部室间隔缺损的对比研究［J］. 中华心血管病杂志，2004，32（5）：398－401.

［3］ 周达新，葛均波，陈灏珠. 室间隔缺损封堵治疗的疗效和安全性［J］. 中华心血管病杂志，2003，31（5）：330－333.

［4］ 李军，张军，姚志勇，等. 经胸超声心动图对室间隔缺损封堵术的选择标准和方法学研究［J］. 中国超声医学杂志，2003，19（8）：584－587.

［5］ Holtzer R, Balzer D, Cao QL, et al. Device closure of muscular ventricular septal defects using the Amplatzer muscular ventricular septal defect occluder: immediate and midterm results of a U.S. registry［J］. J Am Coll Cardiol, 2004,43:1257-1263.

［6］ Hijazi ZM, Hakin F, Haweleh AA, et al. Catheter closure of perimembranous ventricular septal defects using the new Amplatzer membranous VSD occluder: initial clinical experience［J］. Catheter Cardiovasc Interv, 2002,56:508-518.

备注/Memo

备注/Memo:
收稿日期：2004-12-30.
更新日期/Last Update: 2010-01-05