三维超声评价Dor法切除左心室室壁瘤对左心室形态和功能的影响  

A preliminary research to evaluate the effects of Dor procedure on left ventricular three-dimensional shape and function

作　　者：朱丹[1] 赵强[1] 潘翠珍[1] 王宜青[1] 夏利民[1] 

机构地区：[1]复旦大学附属中山医院上海市心血管病研究所心外科,上海200032

出　　处：《中华胸心血管外科杂志》2006年第3期180-182,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的使用三维超声建立一种新的左心室形态定量指标,评价Dor法室壁瘤切除术对左心室形态和功能的影响。方法2003年5月至2004年4月,18例冠心病病人,根据术前二维心脏超声诊断,分为室壁瘤组、左心室扩大组和正常对照组,每组6例。比较3组病人术前、术后心功能和心室三维形态指数(心室锥度,C值)的变化。结果3组均无手术死亡。正常对照组术前、术后的EF、左心室容积、形态没有明显变化。室壁瘤组术后左心室容积明显减少,EF从术前0.43±0.06提高到术后0.54±0.08(P=0.02);左心室三维形态更接近类圆锥体(C值接近于1),舒张心室锥度从术前0.36±0.04提高到术后0.56±0.04(P=0.02),收缩末心室锥度从术前0.42±0.03提高到术后0.60±0.05(P=0.03)。室壁瘤组心室形态改善显著。结论Dor法能有效改善左心室室壁瘤病人的心功能和心室形态。三维超声是进行心室形态定量研究的精确、有效、经济的新手段。Objective To develop a new ventricular index to evaluate the effects of Dor procedure on left ventricular function and shape.Methods From May 2003 to March 2004,18 patients with coronary heart disease were divided into three groups according to the preoperative data of the echocardiograph.The data of the cardiac function and the three-dimensional ventricular shape index were analyzed before and after operation.Results There was no death in three groups.The change the cardiac function and ventricular shape in the normal ventricular group were not apparent. The EF of Dor group increased from 0.43±0.06 preoperafivdy to 0.54±0.08, （P=0.02） postoperatively. Left ventricnlar shape becomes more conical after operation than it was before operation （conicity closer to 1）. The shape of Dor group changed most significantly among the three groups. Condusion The Dor procedure can improve the cardiac function and the ventricular shape of the patienta with left ventricular aneurysm effectively. The 3D echocardiography promised a potent raethod to quantify the ventricnlar shape.

关 键 词：心脏室壁瘤 冠状动脉疾病 心脏外科手术 超声心动描记术 三维 

分 类 号：R654.2[医药卫生—外科学]