房间隔缺损介入治疗中超声测量房缺最大径与球囊伸展径的相关研究  

Correlative study between the largest ASD diameter measured by echocardiography and balloon stretched diameter

作　　者：张玉顺[1] 张军[2] 吴栋良 代正学[1] 李寰[1] 刘建平[3] 贾国良[1] 

机构地区：[1]第四军医大学西京医院心血管内科,陕西西安710032 [2]第四军医大学西京医院超声科,陕西西安710032 [3]第四军医大学西京医院小儿科,陕西西安710032

出　　处：《心脏杂志》2002年第2期154-156,共3页Chinese Heart Journal

摘　　要：目的 :分析房间隔缺损 (ASD)直径的经胸超声心动图 (TTE)和经食管超声心动图 (TEE)测量的最大径与球囊导管测量的 ASD伸展直径 (BSD)的关系 ,探讨在 ASD介入治疗中用超声心动图测量 ASD最大值替代 BSD的可能性。方法 :全组共 5 4例 ,年龄 7.0～ 6 5 (30士 19)岁。按照 ASD边缘状况的不同分为硬缘组 (A组 ) :38例 ,超声显示房缺周缘较长、较硬者或 (和 )边缘为硬缘和极软缘组成 ,而剔除极软缘者 ;软缘组 (B组 ) :16例 ,超声显示房缺缘较软或甚软但较长者。结果 :1TTE和 TEE测量 ASD的最大径之间无显著差异 ,但均明显小于 ASD的BSD(P<0 .0 1) ;2 TTE和 TEE测量 ASD的最大径与 BSD显著相关 (r=0 .86 ,0 .83,P<0 .0 1)。 3A组 TTE和TEE测量 ASD的最大径与 BSD非常接近 ,相关程度更好 ;4B组超声房缺测值往往明显小于 BSD,相关较低。结论 :ASD直径的球囊测量值仍应作为选择封堵器的“金标准”。对于房缺周缘为硬缘者 ,TTE能较准确地独立估测ASD直径并可代替球囊测量 ;对于房缺周缘为软缘者 ,则仍需应用球囊测量。AIM: To investigate the feasibility of the largest ASD diameter measured by echocardiography instead of balloon stretched diameter(BSD) of ASD in transcatheter interventions to analyze the relation of ASD diameter measured by transthoracic and transesophageal echocardiography(TTE and TEE) to BSD. METHODS: There were 40 patients with the age of 30±19 years (ranging from 7 to 65 years). The patients were divided into 2 groups according to ASD edge. In group A(n=38), ASD with solid edge or/and ASD with very soft and floppy edge attached to solid basement and only the solid basement be measured with TTE and TEE. In group B (n=16) , ASD with soft and floppy edge be measured with TTE and TEE. RESULTS: There was no significant difference between the largest ASD diameter sizes measured by TTE and TEE(P>0.05) . The largest ASD diameter sizes of ASDs measured with TTE and TEE were much smaller than BSD (P<0.01). A good correlation was found between the TTE or TEF and BSD (r=0.83 for TTE and BSD,r=0.86 for TEE and BSD,P<0.01) in measurement of ASD size. The largest ASD diameter sizes of ASDs measured with TTE and TEE were similar to BSD in group A. But the largest ASD diameter sizes of ASDs were smaller significantly than BSD in group B (P<0.01). CONCLUSION: The balloon stretched diameter still should be 'golden standard' of selecting the diameter of occluder. TEE can be used to select the patients suitable for transcatheter interventions independently in the following conditions:①ASD with solid edge; ② ASD with very soft and floppy edge attached to solid basement and only the solid basement be measured with TEE. However, BSD should be measured in ASD with soft and floppy edge.

关 键 词：房间隔缺损 介入治疗 超声心动描记术 

分 类 号：R541.1[医药卫生—心血管疾病]