多普勒超声技术评价心房间隔缺损修补术前后心内血流动力学  

Doppler Echocardiographic Assessment of Preoperative and Postoperative Hemodynamics in Atrial Septal Defects

作　　者：李澎[1] 刘汉英[1] 刘延玲[1] 樊朝美[1] 程克正[1] 

机构地区：[1]中国医学科学院中国协和医科大学

出　　处：《中国循环杂志》1997年第3期179-181,共3页Chinese Circulation Journal

摘　　要：目的：探讨用多普勒超声技术评价心房间隔缺损修补术前后各瓣膜血流速度特点。方法：测量１１６例心房间隔缺损患者手术前后缺损的大小及各瓣膜的前向血流速度和过隔分流速度。结果：①术前三尖瓣（０．８０～１．２８ｍ／ｓ，平均１．０５ｍ／ｓ）及肺动脉瓣（０．９６～２．７６ｍ／ｓ，平均１．８６ｍ／ｓ）前向血流速度较正常人增快；主动脉瓣前向血流速度（０．８１～１．２９ｍ／ｓ，平均１．０５ｍ／ｓ）偏低。三尖瓣流速／二尖瓣流速（Ｖｔ／Ｖｍ）及肺动脉瓣流速／主动脉瓣流速（Ｖｐ／Ｖａ）均发生倒置。②术后三尖瓣、肺动脉瓣流速较术前显著下降（Ｐ＜０．００１），主动脉瓣流速则较术前升高（Ｐ＜０．０２）。Ｖｔ／Ｖｍ、Ｖｐ／Ｖａ恢复正常。③心房间隔缺损的大小与年龄呈正相关（ｒ＝０．３３，Ｐ＜０．００１）。术前三尖瓣流速及Ｖｔ／Ｖｍ均与心房间隔缺损大小呈正相关（ｒ＝０．３２、０．３６，Ｐ均＜０．００１）。结论：多普勒超声技术对心房间隔缺损的术前诊断及术后评价有较高的参考价值。Objective:To study the value of the assessment of pre and postoperative hemodynamics in patients with atrial septal defect(ASD)by Doppler echo technique. Methods:We studied 116 patients of ASD with Doppler echocardiography performed pre and postoperatively.Male 45,female 71,aged between 1 and 51 y(mean 20±13 y).The size of ASD was determined by 2 dimensional echocardiography or color Doppler flow imaging(CDFI).The intracardiac flows of every valve orifice and the orifice of ASD were measured by Doppler echo technique. Results:①The preoperative flow velocity of tricuspid valve(TV)(0 80—1 28 m/s,mean 1 05 m/s)and pulmonary valve(PV)(0 96—2 76 m/s,mean 1 86 m/s)in patients was higher than normal but that of aortic valve(AV)(0 81—1 29 m/s,mean 1 05 m/s)was lower.The ratios of TV/MV(Vt/Vm)and PV/AV(Vp/Va)were reversed.②The postoperative flow velocity of either TV or PV was less than preoperative one,while that of AV was increased( p <0 02).The ratios of Vt/Vm and Vp/Va were recovered.③The size of ASD correlated well with patients′ age( r =0 33, p <0 001),the velocity of tricuspid valve( r =0 32, p <0 001)and the ratio of Vt/Vm( r =0 36, p <0 001). Conclusions:The assessment of pre and postoperative hemodynamics in patients with ASD by Doppler technique agrees with the physiopathological changes of the disease.The cardiac flow velocities,Vt/Vm,Vp/Va,shunt flow velocity,the size of ASD and patient′s age are reliable parameters in diagnosing preoperatively and assessing postoperatively.

关 键 词：超声心动图 房间隔缺损 修补术 血流动力学 

分 类 号：R654.2[医药卫生—外科学]