超声在先天性心脏病重度肺动脉高压手术适应证中的评判作用  

Echocardiographic Evaluation of Operative Indication on Severe Pulmonary Hypertension with Congenital Heart Disease in Adults by Doppler Echocardiography

作　　者：游昕[1] 钱维源[2] 马游[1] 陈若为[1] 梁勇[1] 徐恩五[1] 

机构地区：[1]解放军第四五四医院心胸外科,江苏南京210002 [2]解放军第四五四医院特诊科,江苏南京210002

出　　处：《中国误诊学杂志》2009年第32期7813-7815,共3页Chinese Journal of Misdiagnostics

摘　　要：目的:总结超声检查评判成人先天性心脏病(CHD)合并双向分流型重度肺动脉高压(PH)手术适应证的经验。方法:32例心脏超声检查:CHD合并重度PH,缺损水平双向分流。以下列指标评判手术适应证:(1)心脏超声:左向右分流的峰值流速、分流时间均不低于右向左分流;左向右分流与右向左分流频谱的速度-时间积分比值>1.85;(2)肺循环、体循环收缩压比值(Pp/P s)<1.0;(3)股动脉血气分析:PaO2≥60 mm Hg,SaO2≥0.90;(4)无静息发绀。手术在体外循环下进行。结果:全组无死亡。复查心脏超声:无残余分流;Pp/P s下降。结论:心脏超声检查可准确、便捷地判断CHD合并重度PH患者的手术适应证。Objective：To evaluate the clinical value of operative indication using doppler echocardiography in estimation to congenital heart disease（CHD） with severe pulmonary hypertension（PH） with bidirectional shunt in adults.Methods：The clinical data of 32 patients with CHD were studied retrospectively.All patients accepted echocardiography measure showed bidirected shunt at the defects.Operative indication：（1）Peak systolic velocity,pressure gradient,shunt time and evaluated shunt volume of left to right shunt phases were not less than which of right to left shunt phas es, The ratio of velocity time inlegrant of shunt frequency of left to right shunt phases to which of right to left shunt phases was above 1.85. （2）The ratio of pulmonary systolic pressure to systemic systolic pressure（Pp/Ps） was less than 1. 0. （3）Blood （femoral artery） gas analysis：PaO2≥60 mm Hg,SaO2≥0. 90, （4）No cyanosis in resting condition, All cases underwent open heart surgery. Results：None died and none residual shunt. Conclusion ：To evaluate operative indication to CHF） with severe PH is maybe a reliable and simple method which associate with doppler echocardiography and blood gas analysis.

关 键 词：心脏缺损 先天性/并发症/超声检查 高血压 肺性/并发症/超声检查 

分 类 号：R541.5[医药卫生—心血管疾病]