放射核素肺灌注显像评价小儿先天性右心梗阻性疾病双向Glenn术后肺血流分布  

Pulmonary flow study after pulsatile bidirectional Glenn shunt with radionuclide pulmonary perfusion imaging for congenital obstructive diseases of right heart

作　　者：谭敏[1] 郑彦[2] 秦迁[1] 李刚[1] 姬尚义[1] 王成林[2] 

机构地区：[1]深圳市孙逸仙心血管医院外科,广东深圳518020 [2]北京大学深圳医院

出　　处：《罕少疾病杂志》2005年第4期1-2,6,共3页Journal of Rare and Uncommon Diseases

基　　金：吴阶平医学基金会临床科研资助项目(编号:2005-86-F)

摘　　要：目的初步探讨放射核素肺灌注显像(radionuclidepulmonaryperfusionimaging,RPPI)定量评价小儿先天性右心梗阻性疾病行搏动性双向Glenn术后肺血流改善的价值。方法20例2～14岁先天性右心梗阻性疾病患儿均接受搏动性双向Glenn术。术前经上肢静脉、术后分别经上下肢静脉注入显像剂,取后前位及前后位行放射核素肺灌注显像,分别采集相应的两肺、和/或两肾计算放射性计数。分析对比术前术后双侧肺RPPI、术前术后右向左分流指数,经SAS软件系统处理。结果本组病例术后上下腔静脉血均回流至左右肺且明显增加,放射性计数比值无显著性差异。双侧肺血分布基本对称,术后右向左引流减少有显著差异。结论放射核素肺灌注显像能明确反映搏动性双向Glenn术后肺血流改善状况。Objective To study pulinonary flow in both lungs qualitatively and quantitatively after pulsatile bidirectional Glenn（PB Glenn） shunt with radionuclide pulmonary perfusion ilnaging（RPPI） for congenital obstructive diseases of right heart（CODRH）. Methods Twenty patients with CODRH reffered for PB Glenn shunt were studied with RPPI. Radionuclide agent was injected ii1 upper limb preoperatively, and separately in upper limb and lower limb postoperatively. Inlaging was performed in 1）oth anteroposter^or and posteroanterior positions after balance of radioactive tracers in both lungs was achieved. 5×10^5 radioactive counts were acquired in each positioi1. Results There was no marked difference between the one lung counts to the total counts of two lungs ratios of left and right lung, and blood flow was evenly distributed in two lungs after PB Glenn shulat. Right to left shunt was decreased markedly after PB Glenn. Concluslon Marked increase and distribution of blood flow to bilateral lungs could be achieved after PB Gleen procedure. The above conditions could be reflected noninvasively and exactly by RPPI.

关 键 词：心脏缺损 放射核素肺灌注显像 小儿先天性右心梗阻性疾病 双向GLENN术 肺血流分布 

分 类 号：R541.1[医药卫生—心血管疾病] R452[医药卫生—内科学]