经食管超声与心导管同步定量冠状动脉旁路移植术前后肺动脉楔压的研究  

Evaluation on changes of pulmonary capillary wedge pressure in patients undergone off-pump coronary artery bypass using transesophageal echocardiography and cardiac catheterization simultaneously

作　　者：康友文 康维强[1] 赵林[1] 杜日映[1] 万峰[1] 马骏[1] 柏本健[1] 

机构地区：[1]青岛市海慈医院心内科

出　　处：《中华超声影像学杂志》2005年第5期342-345,共4页Chinese Journal of Ultrasonography

摘　　要：目的应用经食管超声(TEE)和心导管技术同步检测微创冠状动脉旁路移植术(OPCABG)前、后肺动脉楔嵌压(PCWP)的变化。方法应用TEE检测46例患者OPCABG术前后二尖瓣血流频谱(MVF)和肺静脉血流频谱(PVF),同步应用心导管技术检测PCWP。对术前、术后所测量指标进行对比分析,并将PCWP与TEE所测指标进行相关分析。结果OPCABG术后TEE测量的反映左室收缩舒张功能的指标和PCWP较术前有明显改善(P<0.01～0.05);MVF与PVF的多数指标与PCWP有相关性(r=0.30～0.76,P<0.01～0.05),其中反向A波峰值血流速度(PVa)、反向A波速度时间积分(VTIpva)及MVF与PVF相结合的指标Tpvadt mvadt、Tpvat mvat与PCWP相关性最好(r=0.75～0.89,P<0.001)。结论OPCAB术后即刻左室功能改善,TEE检测PVF和MVF可用来准确估算PCWP,对OPCAB疗效进行评价。Objective To investigate the changes of pulmonary capillary wedge pressure(PCWP) before and after off-pump coronary artery bypass graft(OPCABG) using transesophageal echocardiography(TEE). Methods Mitral valve flow(MVF) and pulmonary veinous flow(PVF) were measured in 46 patients before and after OPCAB using TEE and PCWP was detected by cardiac catheter. The correlations between indices derived from TEE and catheterization-measured PCWP and the differences before and after OPCAB were studied. Results There were obvious differences in the indices derived from TEE and PCWP which could reflect the left ventricular function. The most indices measured in PVF and MVF correlated with PCWP(r=(0.30)-(0.76),P<(0.01)-(0.05)),among which PVa,VTIpva of PVF and Tpvadt-mvadt,Tpvat-mvat combined PVFand MVF most highly correlated with PCWP(r=(0.75)-(0.89),P<(0.001)).Conclusions The indices derived from MVF and PVF measured by TEE can be used to estimate PCWP simply and noninvasively and assess OPCAB efficiently. The left ventricular function has been significantly improved immediately after OPCAB.

关 键 词：经食管超声 术前后 肺动脉楔压 微创冠状动脉旁路移植术 肺静脉血流频谱 二尖瓣血流频谱 PCWP 定量 肺动脉楔嵌压 OPCABG 收缩舒张功能 CABG术后 峰值血流速度 心导管技术 TEE PVF 同步检测 技术检测 对比分析 测量指标 

分 类 号：R654.3[医药卫生—外科学]