感染性心内膜炎超声诊断与手术结果的对照研究  

Comparative study on findings between transthoracic echocardiography and surgery in infective endocarditis

作　　者：纳丽莎[1] 王竞靖[1] 刘俊英[2] 徐艳萍[2] 刘蕊[2] 

机构地区：[1]宁夏医科大学附属医院,宁夏银川750004 [2]宁夏医科大学,宁夏银川750004

出　　处：《宁夏医学杂志》2010年第12期1120-1122,F0003,共4页Ningxia Medical Journal

摘　　要：目的探讨经胸超声心动图(TTE)在诊断心脏赘生物和瓣膜损害,由此指导临床诊断和治疗感染性心内膜炎(IE)方面的重要价值。方法应用TEE观察33例IE患者赘生物附着部位、形态、大小、回声、活动情况,瓣膜返流及其程度,有无脱垂及其程度,有无腱索断裂和瓣膜穿孔,有无瓣周脓肿和瓣周漏等,并将超声诊断与手术结果进行对照。结果 TTE诊断瓣膜赘生物31例,提示2例赘生物;手术证实31例赘生物(诊断符合率93.94%)。超声和手术证实赘生物附着部位完全一致:主动脉瓣8例(25.81%),二尖瓣10例(32.26%),联合附着6例(19.35%),三尖瓣4例(12.90%),肺动脉瓣3例(9.68%)。超声和手术证实瓣膜损害:中度以上返流(20例/60.61%,vs 20例/64.52%)、穿孔(5例/15.15%,vs6例/19.35%)、脱垂和/或腱索断裂(7例/21.21%,vs 7例/22.58%)、瓣周漏(1例/3.03%,vs 1例/3.23%)。结论 TTE能够敏感发现赘生物以及附着部位瓣膜的损害,对指导临床正确诊断和治疗IE具有非常重要的价值。Objective To discuss the clinical significance in diagnosing vegetation and valvular lesion,and in guiding clinical diagnosis and treatment for infective endocarditis（IE） by transthoracic Echocardiography（TTE）.Methods The location,shape,size,echo and mobility of vegetation,valvular lesion,regurgitation and it＇s extent,prolapse and it＇s extent,rupture of chord,valvular perforation,and para-valvular abscess and leak for prosthetic valve were observed in 33 cases with IE and compared the findings between TTE and surgery.ResultsTTE diagnosed 31 cases sized from 4mm to 24mm and suspected 2 cases with vegetation,and the surgery confirmed 31cases（coincidental rate was 93.94%）.The location of vegetation confirmed by both TEE and surgery were： 8 cases（25.81%） on aortic valve,10 cases（32.26%） on mitral valve,6 cases（19.35%） on the both,4 cases（12.90%） on tricuspid valve,and 3 cases（9.68%） on pulmonic valve.Valvular lesion by TTE and surgery respectively were： moderate and more valvular regurgitation（20 cases/60.61% vs.20 cases/ 64.52%）,valvular perforation（5cases/15.15% vs.6 cases/19.35%）,valvular prolapse and/ or rupture of chord（7cases/21.21% vs.7cases/22.58%）,para-valvular leak（1case/3.03% vs.1case/3.23%）.ConclusionTTE is sensitive in diagnosing vegetation and valvular lesion;and is of clinical significance in diagnosis and treatment for IE.

关 键 词：感染性心内膜炎 经胸超声心动图 赘生物 

分 类 号：R445.1[医药卫生—影像医学与核医学]