超声心动图评价Dor法切除左心室室壁瘤术后对左心室形态和功能的影响  

Evaluating effects of Dor operation on left ventricular function and shape by echocardiography

作　　者：潘翠珍[1] 朱丹[1] 舒先红[1] 赵强[1] 陈灏珠[1] 

机构地区：[1]复旦大学附属中山医院心内科上海市心血管病研究所,上海200032

出　　处：《中华超声影像学杂志》2005年第12期889-891,共3页Chinese Journal of Ultrasonography

摘　　要：目的研究Dor法切除左心室室壁瘤术前、术后左心室二维形态的变化,了解该手术对左心室形态和功能的影响.方法采用Philips Sonos 5500超声诊断仪和S4探头,比较室壁瘤组(28例,治疗方法为Dor法合并或不合并冠状动脉搭桥术)和对照组冠心病无室壁瘤组(15例,治疗方法为仅行冠状动脉搭桥术)术前、术后心功能和二维形态指数的变化.结果室壁瘤组:手术死亡2例(7.1%);随访1～54月,平均(28.5±6.4)月,死亡2例(7.1%);存活患者左室射血分数从术前的0.37±0.09提高到术后的0.49±0.09(P＜0.01);术后左心室形态更接近椭圆形,舒张末偏心指数从术前的0.57±0.12提高到术后的0.68±0.18(P＜0.01),收缩末舒张末偏心指数从术前的0.63±0.15提高到术后的0.69±0.11(P＜0.05).对照组:随访4～19月,平均(11.2±4.6)月,无手术死亡和远期死亡,术前、术后左室射血分数和左心室形态无明显变化(P＞0.05).两组舒张末、收缩末偏心指数术后差别无显著性意义(P＞0.05).结论Dor法能有效改善左心室室壁瘤患者的心功能和心室形态.Objective To evaluate the effects of the Dor operation on left ventricular（LV） function and shape by two-dimensional echocardiography（2DE） in the patients with LV aneurysm. Methods Dor- group： the patients with LV aneurysm（28 cases） were treated with Dor operation [with or without coronary artery bypass grafting（CABG）], control group： the patients with normal cardiac function （15 cases） underwent the operation CABG only. LV function and two-dimensional LV shape index were compared between Dor group and control group before and after operation. Results The operative mortality rate of Dor group was two cases（7.1 %）, and late mortality rate was two cases（7.10%） of （28.5 ± 6.4） months by follow-up observation, left ventricular ejection fraction（LVEF） increased from 0.37 ± 0.09 preoperatively to 0. 49 ＋ 0.09 postoperatively（ P 〈0. 01 ）, and LV shape became more elliptical after operation than that before operation. In a follow-up 4- 12 months,averaging（11.2 ± 4.6） months there was no operative and long-term death in control group, there was no apparent change of LVEF and eccentricity index before and after operation. And also there was no significant difference of the postoperative eccentricity index between the two groups. Conclusions Dor operation can improve the LV function and LV shape of the patients with LV aneurysm effectively.

关 键 词：超声心动描记术 心脏室壁瘤 心室功能 左 

分 类 号：R445.1[医药卫生—影像医学与核医学]