床旁超声检查诊断婴幼儿心脏手术后上腔静脉梗阻  

Bedside ultrasonographic diagnosis in children with superior vena cava syndrome after cardiac operations

作　　者：李永青[1] 罗毅[1] 程沛[1] 

机构地区：[1]首都医科大学附属北京安贞医院小儿心脏科,北京100029

出　　处：《中华超声影像学杂志》2005年第4期282-284,共3页Chinese Journal of Ultrasonography

摘　　要：目的探讨先天性心脏病手术后上腔静脉(SVC)梗阻综合征患儿的床旁超声表现及其在临床诊疗中的意义.方法先天性心脏病矫治术后患儿6例,于术后第5～38 h[平均(22±11)h]临床怀疑有SVC梗阻,行床旁超声检查,全面显示SVC及其主要属支的二维结构和血流状况.确诊SVC梗阻后立即二次开胸手术治疗.结果5例患儿为SVC近心段不全梗阻,表现为管腔狭窄,血流呈持续高速湍流,在呼吸周期中的变化及在心动周期中的时相消失;1例左无名静脉血流显像色彩暗淡,近于完全梗阻.手术证实上述结果.所有患儿恢复良好,出院前超声检查示受累静脉血流正常.结论床旁超声检查可以及时、准确地诊断先天性心脏病患儿围术期SVC梗阻,有重要的临床意义.Objective To explore the findings and clinical value of bedside ultrasonography in superior vena cava(SVC) syndrome in children after cardiac operations for congenital heart disease. Methods Bedside ultrasonography was performed on 6 children suspected of SVC syndrome after 5-38 hours[(22±11) hours] postoperatively,to view the structure and blood flow of SVC and its main branches. All the patients were reoperated as soon as diagnosed. Results Five children got severe SVC obstruction, marked with stenosis, turbulent, continuous and high velocity in SVC. Color Doppler flow imaging presented almost absence of flow due to nearly complete occlusion of the innominate vein in 1 child. Ultrasonographic diagnosis was confirmed by the reoperative findings. All the patients were cured by reoperation and discharged with normal ultrasonographic results. Conclusions Bedside ultrasonography can provide early and accurate diagnosis in children with SVC syndrome after cardiac operation.

关 键 词：超声诊断 婴幼儿 心脏手术 上腔静脉梗阻 床旁超声 术后 

分 类 号：R445.1[医药卫生—影像医学与核医学]