超声心动图评价房间隔缺损封堵术心脏血流动力学及其负荷的变化  

Echocardiographic evaluation of cardiac hemodynamics and load changes after atrial septal defects occlusion

作　　者：石晶[1] 张军[1] 李军[1] 李利[1] 左健[2] 

机构地区：[1]第四军医大学西京医院超声诊断科 [2]第四军医大学西京医院心脏外科,陕西西安710032

出　　处：《心脏杂志》2007年第5期559-562,共4页Chinese Heart Journal

摘　　要：目的应用经胸超声心动图（TTE）评价房间隔缺损（ASD）封堵术前、后心脏血流动力学及负荷的变化。方法西京医院ASD封堵术患者30（女23，男7）例，年龄4．5～63（28±18）岁。于封堵术前、术后3d、3个月及6个月行TTE检查。测量肺动脉瓣口、三尖瓣口血流速度，左、右心室和心房大小变化。结果ASD封堵术后3d、3个月、6个月：肺动脉瓣口最大流速、平均流速、速度时间积分以及三尖瓣口E峰和A峰值血流速度较术前显著降低（P〈0．01）；肺动脉中段内径、右心房和右心室各径较术前显著减小（P〈0．01）；左心房、左心室各径较术前增大（P〈0．05，P〈0．01）。术后各个时间点比较各指标也有不同程度改善。结论ASD封堵治疗后患者血流动力学异常和心腔前负荷变化得以纠正。TTE在ASD封堵术后的疗效观察中具有重要的作用。AIM To evaluate the changes of hemodynamics and cardiac load before defect （ASD） occlusion by transthoracic echocardiography （TTE）. METHODS and after atrial septal rITE was performed, before and 3 days, 3 months and 6 months after ASD occlusion, in 30 patients with ASD [ female 23, male 7 ; aged from 4.5 to 63 （28±18） years ]. The velocity of pulmonary artery and tricuspid valve, and the size of left ventricle and atrium as well as right ventricle and atrium were measured. RESULTS Compared with those before ASD occlusion, the maximal velocity, mean velocity and velocity-time integral of pulmonary artery as well as E peak and A peak velocity of tricuspid valve were significantly reduced （ P 〈 0.01 ） and the middle part diameter of pulmonary artery and all diameters of fight atrium and ventricle were markedly decreased （ P 〈 0.01 ）. The diameters of left atrium and ventricle were significantly augmented （P 〈 0.05 ,P 〈 0.01 ）. Improvement of different degree was also observed at 3 days, 3 months and 6 months after ASD occlusion. CONCLUSION The abnormal hemodynamics and preload change of cardiac chamber of patient with ASD are corrected after the treatment of occlusion. TTE is a valuable method to observe the effect of ASD occlusion.

关 键 词：超声心动图 房间隔缺损 封堵 

分 类 号：R541.1[医药卫生—心血管疾病] R540.45[医药卫生—内科学]