多普勒超声心动图对二尖瓣及主动脉瓣置换术的诊断价值  

Diagnostic value of Doppler echocardiography in patients undergoing mitral and aortic valve replacement

作　　者：罗丽敏[1] 黄枢[1] 

机构地区：[1]中国人民解放军第174医院超声科,福建厦门361000

出　　处：《医学影像学杂志》2016年第9期1582-1586,共5页Journal of Medical Imaging

基　　金：南京军区医学科技创新课题(项目编号:10MA067)

摘　　要：目的 探究采用多普勒超声心动图诊断二瓣置换术的临床效果。方法 选择2010年12月~2015年12月收治的行二尖瓣及主动脉瓣机械瓣双瓣膜置换术患者186例,对患者手术前后心动图情况进行分析。结果 所有患者术后LA、LV均显著低于术前,RV、LVEF以及LVFS显著高于术前,差异显著（P〈0.05）。以二尖瓣狭窄为主的患者术后LA、LAA、LV、LAV、MPGmv、VTImv和PHTmv均低于术前,差异显著（P〈0.05）。术后EOAmv和EOAImv显著高于术前,差异显著（P〈0.05）。以二尖瓣反流为主的患者术后LA和LV低于术前,差异显著（P〈0.05）。以主动脉瓣狭窄为主的患者术后LV、LVM、LVMI、IVS、Vav、MPGav均低于术前,差异显著（P〈0.05）。而术后EOAav、EOAIav高于术前,差异显著（P〈0.05）。以主动脉瓣反流为主的患者术后LV、LVMI、LVM、EOAav以及EOAIav均低于术前,差异显著（P〈0.05）。术后Vav和MPGav高于术前,差异显著（P〈0.05）。二尖瓣部位的人工心脏瓣膜不匹配情况优于主动脉瓣部位,差异显著（P〈0.05）。结论 给予心脏瓣膜病患者二瓣置换术可有效改善左心功能和血流动力学指标,但无法达到正常水平,对于主动脉瓣部位需注意人工心脏瓣膜不匹配发生情况,并采取有效预防措施。Objective To explore the clinical effect of Doppler echocardiography in the diagnosis of mitral replacement surger- y. Methods 186 patients who had received mitral and aortic valve, double valve replacement with mechanical prosthetic valve in our hospital between December 2010 and December 2015 were selected. The echocardiography results of the patients were ana- lyzed before and after surgery. Results After the surgery, the LA and LV of all the patients were significantly lower than before surgery, and RV, LVEF and LVFS were significantly higher than before, with statistically significant difference （ P 〈 0.05 ）. For patients with mitral stenosis, the LA, LAA, LV, LAV, MPGmv, VTImv and PHTmv after the surgery were all lower than before the surgery, and the differences were significant （ P 〈 0.05 ）. Postoperative EOAmv and EOAImv were shown to be significantly higher than fore surgery, where the difference was significant （ P 〈 O. 05）. For patients with mitral regurgitation, the LA and LV after the surgery were both lower than before the surgery, and the difference was significant （ P 〈 0.05）. For patients with aortic valve stenosis, the LA, LAM, IVS Vav and MPGav after the surgery were all lower than before the surgery, and the differences were significant （ P 〈 0.05） ; Postoperative EOAav and EOAIav were shown to be significantly higher than fore surgery, where the difference was significant （ P 〈 0.05）. For patients with aortic regurgitation, the LA, LAMI, EOAav and EOAIav after the surgery were all lower than before the surgery, and the differences were significant （ P 〈 0.05 ） ; Postoperative Vav and PGav were shown to be significantly higher than fore surgery, where the difference was significant （ P 〈 0.05 ）. The proportion of mis- match between heart valve prosthesis and mitral valve was less than that between heart valve prosthesis and aortic valve, and the difference was signifieant（ P 〈 0. 05）. Conclusion For patients with valvular heart disease, do

关 键 词：多普勒超声 心动图 二瓣置换术 诊断 

分 类 号：R541[医药卫生—心血管疾病] R445.2[医药卫生—内科学]