实时三维超声心动图评价房间隔缺损不同手术方式的右室收缩功能变化  

Real-time three dimensional echocardiography in evaluating right ventricular systolic function in atrial septal defect patients

作　　者：钱频[1] 高云华[1] 谭开彬[1] 郑嘉荣[1] 文利[1] 夏红梅[1] 王冬 

机构地区：[1]第三军医大学新桥医院超声诊断科,重庆400037

出　　处：《第三军医大学学报》2008年第11期1088-1090,共3页Journal of Third Military Medical University

摘　　要：目的应用实时三维超声心动图(real-time three dimensional echocardiography,RT-3DE)研究房间隔缺损(at-rial septal defect,ASD)不同手术方式右室收缩功能的变化。方法ASD患者按照不同手术方式分为外科手术组和封堵组;常规二维超声心动图检查后,使用RT-3DE采集患者的右室全容积数据库,分析右室舒张末容量(right ventricular enddiastolic volume,RVEDV)和收缩末容量(right ventricular end systolic volume,RVESV)、计算右室射血分数(right ventricularejection fraction,RVEF)。比较术前、术后7d、术后3个月的RVEDV、RVESV、RVEF值变化。结果术后7d,封堵组右室RVEDV、RVESV均较术前明显减小(P<0.05),RVEF值与术前无显著差异;外科手术组右室RVEDV较术前明显减小(P<0.05),但RVESV较术前无统计学差异,并且EF值较术前减低(P<0.05)。术后3个月两组的RVEF值均较术前明显增高(P<0.05)。结论RT-3DE能简便、准确地确定右室容积并计算右室收缩功能;ASD患者外科手术组术后早期右室收缩功能较术前减低,术后3个月恢复到正常水平,封堵组术后初期EF值即达正常水平。Objective To evaluate right ventricular （RV） systolic function before and after different operation methods in the patients with atrial septal defect （ASD） by real-time three dimensional echocardiography （RT-3DE）. Methods ASD patients were divided into two groups： heart surgery group and cardiac implant closure group. After conventional examination by two dimensional echocardiography （2DE） , right ventricular ＂Full Volume＂ imaging was acquired by RT-3DE. Right ventricular end diastolic volume （RVEDV） and end systolic volume （RVESV） were outlined by the analysis software of RT-3DE; RV ejection fraction （RVEF） were calculated. RVEDV, RVESV, RVEF before operation, 7 d and 3 months after operation were compared between the two groups. Results RVEF was lower than 50% in more patients with ASD before operation. Compared with those before heart implant closure, RVEDV and RVESV decreased significantly 7d after cardiac implant closure （ P 〈 0.05 ）, while RVEF showed no significant difference. RVEDV and RVEF in heart surgery group decreased obviously （P 〈 0.05 ） 7d after operation, while RVESV showed no significant difference. RVEF in both groups increased significantly 3 months after operation. Conclusion Real-time three dimensional echocardiography could be used conveniently and accurately to determine right ventricular volume and function. Right ventricular systolic function of ASD patients after heart surgery is decreased in early stage, then improves to normal level 3 months after operation, while that in ASD patients after heart implant closure improves to normal level in early stage after operation.

关 键 词：实时三维超声心动图 房间隔缺损 右室收缩功能 

分 类 号：R331.31[医药卫生—人体生理学] R540.45[医药卫生—基础医学]