经胸彩色超声心动图对房间隔缺损封堵术的指导及疗效观察  

Guiding and Observing of Treatment Efficiency of Transcatheter Closure of Atrial Septal Defects (ASD) with Echocardiography

作　　者：丁守良[1] 张华[1] 丁月梅[1] 刘建平[2] 白梅[3] 任建政[4] 张磊[1] 

机构地区：[1]武警陕西总队医院万科心脏中心导管室,西安710054 [2]第四军医大学西京医院儿科,710032 [3]武警陕西总队医院B超室,710054 [4]武警陕西总队医院放射科,710054

出　　处：《现代医用影像学》2004年第4期159-161,共3页Modern Medical Imageology

摘　　要：目的 :探讨经胸彩色超声心动图 (TTE)对房间隔缺损 (ASD)封堵术病例的选择和术中及术后疗效观察的价值。材料与方法 :封堵术前对 4 8例先天性心脏病房间隔缺损患者进行经胸彩色超声测量房间隔的前后径、左右径 ,及房间隔残留端的长度 ,距离房间隔顶部、距离主动脉壁的距离 ,和三尖瓣、二尖瓣、上、下腔静脉口的距离。封堵术中观察封堵器释放的全过程 ,主要观察封堵器的房间隔缺损处的位置及张开是否正常 ,封堵器是否牢固 ,对瓣膜运动有无阻碍。封堵术后观察心房水平有无残留分流 ,封堵伞有无脱落 ,右房、右室、肺动脉内径有无变化 ,有无二尖瓣、三尖瓣返流。结果 :TTE检测 4 8例ASD封堵术患者 ,TTE测量房间隔缺损左右径平均 2 2 2 7± 6 0 5mm ,上下径 18mm ,平均分流速度 1 5± 0 2 8ml/s。术后 2天复查 ,4 8例右房右室内径缩小 ,心房水平分流消失。封堵器选择大于TTE测量值的 2mm～ 4mm。结论 :TTE检查对于术前选择合适的ASD患者 ,选择ASD封堵器的大小 ,术中监测封堵器位置是否合适 ,术后观察有无残余分流 ,评价疗效有着重要的价值。Purpose:To emplore the value of transthoraiu echocardiography(TTE) in ASD patients choice,monitorment in operation and observtion treatment efficience after operation.Materials and Methods:To measure the diameter of front and behind,left and right of ASD and the distance between ASD and the periphery,namely the top of the atrial septal,the wall of aorta,tricuspid,mitral,superior vena cava,inferiorvena cava.To observe the location of occluder device in ASD is normal or not,and it is firm or not.To observe if there is trival residual shunts in atrial lever after operation,and if there is changment in diameter of right atrial,right ventricular,and pulmonary artery.Results:48 ASD patients were observed.The mean diameter of left and right is 22 27±6 05mm,the mean diameter of superior and inferior is 19 0±3 76mm.the mean velocity of shunts is 1 5m±0 28m/s.The diameter of right atrial and right ventricular is reduced in 48 patients.Shunts in artial lever is disappear.The diameter of occluder device is 2～4mm vider than measure of echocardiography.Conclusion:TTE have important value in choice of suitable ASD patients and the size of occluder device,also help to examine the location is suitable or not in operation,to observe iof there is trival residual shunts after operation and to evaluate the treatment efficiency.

关 键 词：封堵术 封堵器 房间隔缺损 ASD 彩色超声心动图 患者 观察 释放 残留 全过程 

分 类 号：R541.1[医药卫生—心血管疾病]