经胸超声心动图在软缘残端房间隔缺损封堵术中的应用  

Application of Thansthoracic Echocardiography in Occlusion of Atrial Septal Defect(ASD) with Thin Stump

作　　者：陆娟[1] 姚志勇[1] 刘丽赟[2] 刘建平 

机构地区：[1]南京医科大学附属医院明基医院超声科,南京市210019 [2]南昌市第一医院心内科 [3]西安市第四军医大学第一附属医院小儿科

出　　处：《中国超声医学杂志》2014年第5期404-407,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨经胸超声心动图(TTE)指导软缘残端的房间隔缺损封堵术价值。方法 628例残端为软缘的房间隔缺损,纳入标准:(1)房间隔厚度<1 mm;(2)回声低于相邻部位正常房间隔;(3)房间隔摆动幅度>10 mm。术前均采用经胸超声心动图观测各切面缺损的大小及残端情况,选择封堵器;术中监测封堵过程;术后观测封堵器腰部大小,比较封堵器腰部与缺损大小、封堵器大小的关系。结果各切面中,最大房间隔缺损为(20.1±3.5)mm,房缺大小加两侧房间隔残端软缘之和最大为(29.4±1.3)mm,封堵器大小为(26.5±2.1)mm,封堵器腰部最大内径为(23.5±2.4)mm,房缺大小加两侧房间隔残端软缘之和与封堵器大小及封堵器腰部内径之间差异均有统计学意义,P<0.05。房缺大小加两侧房间隔残端软缘之和与封堵器大小及封堵器腰部内径之间相关性良好,分别为r=0.80,P<0.05及r=0.81,P<0.05。所有病例中除1例封堵器释放后脱落经外科手术取出外,其余均封堵成功,无明显其他合并症。结论经胸超声心动图可以指导残端为软缘的房间隔缺损封堵术。Objective To study the value of transthoracic echocardiography （TTE） on occlusion of ASD with thin stump.Methods 628 patients have ASD with thin stump were enrolled in the study,And the standard of thin stump is：（1） the thickness of atrial septum（AS）is ＜1 mm.（2） the echo of AS is lower than that of it＇s acroteric normal AS.（3） the moving amplitude of AS is ＞10 mm.Size and stump of ASD be surveyed by TTE before occlusion,and size of occluder be chosen based on results by echocardiography.Procedure be monitored by TTE during occlusion,measuring size of occluder＇s waist and studying relation between size of occluder and ASD and between size of occluder and it＇s waist.Results In all views,the best size of ASD is（20.1 ± 3.5）mm,and size of occluder is （26.5±2.1）mm,and the best size of occluder＇s waist is （27.3±2.3）mm,and there were significant differences between size of ASD plus thin stump on both sides of ASD and size of occluder and size of occluder＇s waist,P＜0.05.It is a good dependablity between size of ASD plus thin stump on both sides of ASD and size of occluder and size of occluder＇s waist,r=0.80,P＜0.05 and r=0.81,P＜0.05.In all cases,there were successful but 1 occluder was take out by surgery because the occluder was dropped,and there have no other complications.Conclusions TTE is a good means to guide occlusion of ASD with thin stump.

关 键 词：经胸超声心动图 房间隔缺损 封堵术 软缘 

分 类 号：R541.1[医药卫生—心血管疾病] R540.45[医药卫生—内科学]