经食管超声心动图评估肺动脉及肺静脉指数对法洛四联症根治术的指导价值  

Value of transesophageal echocardiography in estimating pulmonary arterial index and pulmonary vein index for guiding total correction of tetralogy of Fallot

作　　者：崔存英 彭帮田[2] 范太兵[2] 黄丹青[1] 张娟[1] 秦芸芸 张连仲[1] 刘琳[1] 

机构地区：[1]河南省人民医院/郑州大学人民医院心血管超声科,郑州450003 [2]河南省人民医院/郑州大学人民医院儿童心脏中心,郑州450003

出　　处：《中华实验外科杂志》2017年第1期137-139,共3页Chinese Journal of Experimental Surgery

基　　金：国家自然科学基金（81401410）;河南省医学科技攻关计划项目（201602173）

摘　　要：目的应用经食管超声心动图（TEE）评估法洛四联症（TOF）患者的肺动脉及肺静脉指数，并探讨其对TOF根治术的指导价值。方法TOF患者80例，术前应用TEE分别测量左、右肺动脉及四支肺静脉内径，计算肺动脉指数（PAI）及肺静脉指数（PVI）并进行统计学分析。结果PAI及PVI相关性良好（r＝0.853，P＝0 .000）。PAI及PVI诊断术后重症监护室（ICU）滞留的受试者工作（ROC）曲线下面积分别为0.704、0.781，最佳分界值分别为147.25、286.42 mm2/m2，相对应的敏感性分别为90%、100%，特异性分别为74%、74%，诊断术后呼吸机辅助时间延长的ROC曲线下面积分别为0.817、0.789，最佳分界值分别为152.48、302.12 mm2/m2，相对应的敏感性分别为90%、90%，特异性分别为75%、77%，诊断术后低心排综合征的ROC曲线下面积为0.955、0.926，最佳分界值分别为130.55、209.09 mm2/m2，相对应的敏感性分别为100%、83%，特异性分别为90%、89%。结论TEE能定量评价TOF患者的PAI及PVI，两种指标相关性良好，对诊断TOF根治术后ICU滞留、呼吸机辅助时间延长及低心排综合征具有较高的敏感性及特异性。Objective To investigate the value of transesophageal echocardiography （TEE） in estimating pulmonary arterial index （PAI） and pulmonary vein index （PVI） for guiding total correction of tetralogy of Fallot （TOF）.Methods 80 patients with TOF were studied. TEE was used to measure the diameters of left and right pulmonary arteries and four pulmonary veins at pre-operation, PAI and PVI were calculated and analyzed statistically.Results There was significant correlation between PAI and PVI （r=0.853, P=0.000）. Receiver operator characteristic curve （ROC curve） analysis showed that the area under the ROC curve of PAI and PVI in detecting prolonged stay in intensive care unit （ICU） after operation were 0.704, 0.781, the border value were 147.25, 286.42 mm2/m2, the sensitivity were 90%, 100%, and the specificity were 74%, 74%, respectively. The area under the ROC curve of PAI and PVI in detecting prolonged mechanical ventilation after operation were 0.817, 0.789, the border value were 152.48, 302.12 mm2/m2, the sensitivity were 90%, 90%, and the specificity were 75%, 77%, respectively. The area under the ROC curve of PAI and PVI in detecting low cardiac output syndrome after operation were 0.955, 0.926, the border value were 130.55, 209.09 mm2/m2, the sensitivity were 100%, 83%, and the specificity were 90%, 89%, respectively.Conclusion TEE can be used as a quantitative method to evaluate PAI and PVI in patients with TOF, there is significant correlation between the two indices, PAI and PVI carry higher sensitivity and specificity in detecting prolonged stay in ICU, prolonged mechanical ventilation and low cardiac output syndrome after operation.

关 键 词：经食管超声心动描记术 法洛四联症 肺动脉指数 肺静脉指数 

分 类 号：R654.2[医药卫生—外科学] R540.45[医药卫生—临床医学]