超声心动图在右室双出口大动脉转换术前后的应用价值  

Application value of echocardiography in the pre-and postoperative assessment of the artery switch operation for the repair of double outlet right ventricle

作　　者：沈蓉[1] 蔡及明 朱俊学[1] 张志芳[1] 陈国珍 吴兰平[1] 洪雯静 张玉奇[1] 

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,上海市200127

出　　处：《临床超声医学杂志》2016年第7期438-441,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨超声心动图在右室双出口(DORV)大动脉转换术前后的应用价值。方法回顾性分析160例经手术证实为DORV,并行大动脉转换术患儿的超声心动图资料,将手术前后的超声检查结果进行对比。结果 160例患儿中,超声术前诊断DORV者155例(96.9%),术前诊断室间隔缺损部位与手术相符者127例(79.3%)。术后补片残余分流者17例;术后超声提示左、右肺动脉流速情况85例(53.1%),其中右肺动脉狭窄29例,左肺动脉狭窄21例。新主动脉瓣反流程度较术前加重者114例,新肺动脉瓣反流程度较术前加重者20例。结论超声心动图可于术前准确诊断DORV及其室间隔缺损部位;术后准确评估半月瓣反流程度、补片残余分流及吻合口残余梗阻的情况,但对于肺动脉分支狭窄的检出较为困难。Objective To evaluate the application value of echocardiography before and after artery switch operation for double outlet right ventricle（DORV）.Methods Echocardiography was performed in 160 patients who underwent artery switch operation for the repair of DORV. Pre-and postoperative data were compared.Results Among 160 patients,DORV was diagnosed correctly by echocardiography in 155 cases（96.9%）,types of ventricle septal defects were diagnosed in accordance with surgical results in 127 cases（79.3%）.Residual shunt of ventricle septal defects occurred in 17 patients. Pulmonary branch was identified by echocardiography in 85 cases（53.1%）,right pulmonary stenosis in 29 cases,left pulmonary stenosis in 21 patients. Compared with findings of pre-operation,neoaortic valve regurgitation were more severe in 114 patients,and neopulmonary valve regurgitation were more severe in 20 patients after surgery.Conclusion Echocardiography can accurately diagnose DORV,identify the types of ventricle septal defects before operation,and assess valve regurgitation,residual shunt of ventricle septal defects and residual anastomosis obstruction after surgery. However,it is difficult to identify neopulmonary branch by echocardiography.

关 键 词：超声心动描记术 右室双出口 大动脉转换术 

分 类 号：R725.4[医药卫生—儿科] R540.45[医药卫生—临床医学]