部分型肺静脉畸形引流的超声诊断体会  

The Experience of Echocardiography in the Diagnosis of Partial Anomalous Pulmonary Venous Connection

作　　者：莫展[1] 王飞[1] 赖玉琼[1] 

机构地区：[1]广东省佛山市第一人民医院心脏B超室,广东佛山528000

出　　处：《中国现代医生》2007年第12Z期130-131,共2页China Modern Doctor

摘　　要：目的总结超声心动图诊断部分型肺静脉畸形引流的经验体会。方法回顾性分析20例诊断为部分型肺静脉畸形引流患者的超声心动图特点,并与手术或心导管检查相对照。结果超声准确诊断15例(75%),静脉畸形引流部位及条数均与手术相符,漏诊2例(10%),误诊3例(15%)。临床确诊的17例病例中,除2例不伴房间隔缺损外,其余15例均合并房间隔缺损。所有病例均表现为右心增大,左心相对性缩小。结论不伴房间隔缺损的右心增大,静脉窦型房间隔缺损,右心增大程度与房间隔缺损大小不相符,提示存在肺静脉畸形引流的可能,应探查显示四条肺静脉。1￣3条肺静脉引流入右房或体静脉为超声诊断部分型肺静脉畸形引流的直接征象。熟悉正常肺静脉解剖关系及超声探查显示方法,重视此病的存在并多切面仔细观察可减少漏诊和误诊。Objective To summarize the experience of echocardiography in the diagnosis of partial anomalous pulmonary venous connection （PA PVC）. Methods The echocardiographic characters in 20 cases with PAPVC were retrospectively analysed, and compared with the results of surgery or cardiac catheterization. Results 15 cases （75%）with PAPVC were accurately diagnosed by echocardiography, the connective site and numbers of anomalous pulmonary vein were coincident with the surgical results. 2 cases （10%） were missed diagnosis. 3 cases （15%） were erroneous diagnosis. In the 17 cases diagnosed by clinic, 15 cases were incorporate with atrial septal defect （ASD） and the other 2 cases were not. In all cases, the right heart dilated,while the left heart deflated relatively. Conclusion The degree of dilation for the right heart is unmatched with the size of ASD in case of the dilated right heart without ASD or sinus venous ASD, it suggests that PAPVC may be found and the four pulmonary veins should be explored. The direct sign for the echocardiographic diagnosis of PAPVC is that 1 to 3 pulmonary veins connect with the right antrum or systemic veins. To be familiar with the normal anatomic connection of pulmonary veins and the method of echocardiographie exploration,to attach importance to the existence of PAPVC and check carefully by multiple sections,all that helps to decrease missed diagnosis and erroneous diagnosis.

关 键 词：超声心动图 部分型肺静脉畸形引流 

分 类 号：R654.3[医药卫生—外科学]