彩色多普勒超声评价改良迷宫手术  

Evaluation of Modified Maze Procedure by Doppler Tissue Imager

作　　者：唐红[1] 黄鹤[1] 刘淑华[1] 肖锡俊[1] 田子朴[1] 石应康[1] 段伟强[1] 徐克海 

机构地区：[1]华西医科大学附属第一医院,成都610041

出　　处：《华西医科大学学报》2000年第1期107-109,共3页Journal of West China University of Medical Sciences

摘　　要：为了解改良迷宫手术患者心房收缩功能恢复及心功能改善情况 ,运用彩色多普勒超声来评价二尖瓣置换术时施行改良迷宫手术患者的手术前、后心房收缩功能和心功能情况。 1 4例风湿性二尖瓣疾病患者 ,狭窄1 1例 ,关闭不全 3例。对照组 1 6例。术前、术后 (半年至 1年 )测量左房、室 ,右房、室内径 ,M型测量左室收缩功能 ,左房后壁运动幅度。多普勒组织成像测量左、右房室瓣环运动速度。结果 :1两组年龄无差异。 2手术组左房后壁运动幅度与对照组之间无差异 (P>0 .0 5 )。手术组左、右房室瓣环 S峰、e峰、a峰运动速度与对照组相比无差异(P>0 .0 5 )。 3二尖瓣狭窄组术后左房、右房较术前明显减小 (P<0 .0 1 )。右室、左室及射血分数 (EF)、短轴缩短分数 (FS)无明显改变。 4二尖瓣关闭不全组术后左房较术前明显减小 (P<0 .0 1 )。左室术后较术前缩小 (P<0 .0 5 )。右房、右室及 EF、FS无明显改变。以上结果显示 ,对于风湿性二尖瓣疾病伴慢性心房纤颤患者 ,二尖瓣置换术时施行改良迷宫手术 ,可恢复心房收缩功能 ,从而减少血栓形成和栓塞的危险 ,并有利于改善患者心功能 。Since 1998 the cardiac surgeons of WCUMS have performed modified maze procedure for treating the patients with rheumatic mitral valve disease accompanied with chronic atrial fibrillation (Af). In this study, echocardiography, especially Doppler Tissue Imager (DTI),was used to evaluate atria contraction and function of such patients before and after the operation. 14 rheumatic mitral disease patients, aged 27 60 years, were chosen; among them, 11 had mitral stenosis, 3 mitral regurgitation.The control group consisted of 16 cases, aged 24 67 years, with normal echocardiogram. Before and half 1 year after the operation, left atrium, left ventricle, right atrium and ventricle were measured, and cardiac function and posterior wall motion of left atrium were measured. Velocity of mitral valve annual and tricuspid valve annual was measured in DTI. The results showed: There was no age difference between the two groups. The motion of posterior wall of left atrium was 4.18±0.37mm in the operation group, 4.09±0.29mm in the control group ( P >0.05). No difference in velocity of mitral/tricuspid valve annual between the two groups was observed; 3 peaks of mitral valve annual were S 0.11±0 02, e 0.11±0 01, a 0.09±0.01(m/s) in operation group, and S 0.08±0.00, e 0.10±0.01, a 0.08±0.01(m/s) in control group, ( P >0.05, respectively); 3 peaks of tricuspid valve annual were S 0.10±0.01 vs 0.11±0 08, e 0.11±0 08 vs 0.10±0.01, a 0.10±0.10 vs 0.09±0.01(m/s),( P >0.05, respectively). The diameter of left atrium after operation in cases of mitral stenosis decreased significantly, compared with that before operation ( P <0 01). The diameter of right atrium after operation decreased significantly, compared with that before operation ( P <0 01).There was no significant change in right ventricle/left ventricle/EF and FS.The diameter of left atrium after operation in cases of mitral regurgitation decreased significantly, compared with that before operation ( P <0.01). The diameter of left ventricle after o

关 键 词：彩色多普勒 迷宫手术 心功能 超声波诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]