经胸超声在肌部室间隔缺损诊断与外科治疗中的应用  

Study on the value of transthoracic echocardiography in the diagnosis and surgical treatment of muscular ventricular septal defects

作　　者：殷璐曼 张玉奇[1] 张志芳[1] 吴兰平[1] 陈丽君[1] 张海波[2] 

机构地区：[1]上海交通大学医学院附属上海儿童医学中心心内科,上海200127 [2]上海交通大学医学院附属上海儿童医学中心心胸外科,上海200127

出　　处：《医学影像学杂志》2013年第2期191-194,共4页Journal of Medical Imaging

摘　　要：目的探讨经胸超声心动图在肌部室间隔缺损诊断及外科治疗中的应用价值。方法 46例肌部室间隔缺损患者接受外科手术治疗,术前经胸超声检查并分型,外科术中分型及修补缺损,术后24h、1个月、3个月行经胸超声检查。结果 46例患者中,术前经胸超声确诊42例(91.30%),漏诊4例(8.70%)。术前超声分型与外科术中分型对照分析,46例患者中42例(91.30%)二者完全吻合。所有患者均顺利行外科修补术,术后死亡5例。术后超声随访,残余分流、房室瓣反流等并发症较多。结论经胸超声心动图可以比较准确地诊断肌部室间隔缺损,但仍容易漏诊、误诊;其在外科治疗术前诊断、术后随访中起重要作用,是一种安全、有效的监测手段。Objective To evaluate the application value of transthoracic echocardiography in the diagnosis and surgical treatment of muscular ventricular septal defect （mVSD）. Methods A total of 46 patients with mVSD underwent surgical repair. The type of mVSD was determined with echocardiography before operation and the results were analyzed in com- parison with operation approach. Echocardiography was performed at 24 h, and 1, 3 months after operation. Results The definite diagnosis rate was 91.30% （42/46） and the missed diagnosis rate was 8. 700/oo （4/46）. There was significant ac- cordance in the type of mVSD detected with echocardiography and the surgical findings, and the coincidence rate was 91.30%（42/46）. All patients underwent surgical operations and 5 of them died. Complications as residual shunt, atrio- ventricular valve regurgitation were observed. Conclusion MVSD could be accurately diagnosed by transthoracic echocar- diography, transthoracic echocardiography plays an important role in the diagnosis before surgical treatment and evaluation the therapeutic effect of mVSD, so, it is a safe and effective guidance technique.

关 键 词：经胸超声心动图 肌部室间隔缺损 外科治疗 

分 类 号：R541[医药卫生—心血管疾病] R445.1[医药卫生—内科学]