经胸超声心动图测值对选择房间隔缺损封堵器型号的价值  

Value of atrial septal defect diameter measured by transthoracic echocardiography for the selection of Amplatzer septal occluder

作　　者：李贵双[1] 张运[1] 由倍安[1] 李继福[1] 纪求尚[1] 孔光明[1] 

机构地区：[1]山东大学齐鲁医院心内科教育部和卫生部心血管重构和功能研究重点实验室,济南250012

出　　处：《中华超声影像学杂志》2007年第8期663-665,共3页Chinese Journal of Ultrasonography

摘　　要：目的：探讨依据经胸超声心动图（TTE）所测房间隔缺损（ASD）大小选择封堵器型号的价值。方法：选择大动脉短轴观、心尖四腔观、剑突下切面观全方位探测ASD位置、大小及与周围组织结构的关系，确定适合介入治疗患者68例。按ASD最大测值将患者分为3组并作为选择封堵器型号的依据：A组为ASD4～14mm（22例）；B组为ASD15～20mm（21例）；C组为ASD21～33mm（25例）。结果：A、B两组均介入治疗成功；C组中2例不成功。所有病例在6个月的随访中无血栓栓塞、封堵器脱落和死亡。TTE所测ASD最大值可以预测成功封堵需要的封堵器大小。A、B、C三组封堵器型号与ASD最大直径平均差值分别为（3．09±2．04）mm、（4．90±2．36）mm和（7．65±3．05）mm。结论：应用TTE在ASD介入封堵术前多切面探测取得ASD的最大直径作为选择封堵器型号的参考值，并以ASD的大小决定所选封堵器型号，简便易行，效果较好。Objective To evaluate the value of atrial septal defect （ASD） diameter measured by transthoracic echocardiography （TTE） for the selection of Amplatzer septal occluder （ASO）. Methods Sixty-eight subjects were enrolled with 15 male and 53 female. The heart base short axis, the apical fourchamber and the subcostal views were obtained to determine the positions,diameters of the ASD,as well as the relationships with the neighbouring structures. The largest diameter was selected as the reference diameter,according to which all patients were separated into 3 groups. Group A： 22 subjects with the largest diameter of ASD4～14 mm; group B： 21 with ASD 15～20 mm; group C： 25 with ASD 21～33 mm. Results All patients in group A and group B were successfully occluded whereas 2 in group C failed. No thromboembolism, ASO dislocation and death occurred in three groups in a 6-month follow-up. Group A： ASD（ X ） （9.68 ±2.83）mm, ASO（ Y ）（ 12.77± 3.96）mm, Y- X = （3.09±2.04）mm, regression equation： Y = 1.22X ＋0.99（ r =0.925, P 〈0.001）;group B：ASD （17.14±1.53）mm,ASO （22.5±2.84）mm, Y- X = （4.90 ±2.36）mm, regression equation： Y = 1.03 X ＋ 4.43 （ r = 0. 976, P d0.001 ） ;group C：ASD （26.87 ± 2.75）mm,ASO （34.52± 4.23）mm, Y- X = （7.65 ± 3.05）mm,regression equation： Y = 1.07 X ＋ 5.89（ r = 0. 929, P （0. 001）. Conclusions It is feasible and satisfactory that measuring the largest ASD diameter by TTE at different echo-views, before ASD interventional closure, to regard it as the reference value for selecting ASO size.

关 键 词：超声心动描记术 房间隔缺损 封堵器 

分 类 号：R686[医药卫生—骨科学]