超声心动图结合右心声学造影在卵圆孔未闭中应用价值  

Application value of patent foramen ovale by echocardiography combined with right heart contrast echocardiography

作　　者：庚靖淞[1] 朱鲜阳[1] 侯传举[1] 于馨[2] 肖家旺[1] 盛晓棠[1] 王琦光[1] 张端珍[1] GENG Jing-song ZHU Xian-yang HOU Chuan-ju YU Xin XIAO Jia-wang SHENG Xiao-tang WANG Qi-guang ZHANG Duan-zhen(Department of Congenital Heart Disease ,The General Hospital of Shenyang Military Command, Shenyang 110016, China)

机构地区：[1]沈阳军区总医院先心病内科,辽宁沈阳110016 [2]沈阳军区总医院特诊科,辽宁沈阳110016

出　　处：《临床军医杂志》2016年第12期1268-1271,共4页Clinical Journal of Medical Officers

基　　金：辽宁省科学技术计划项目(2014225015)

摘　　要：目的探讨超声心动图(UCG)结合右心声学造影(c TTE)在卵圆孔未闭(PFO)中的应用价值,为临床诊断和治疗提供早期参考依据。方法选取沈阳军区总医院自2015年1月至2015年12月住院治疗的怀疑存在PFO的患者51例,行经胸超声心动图(TTE)检查明确是否存在房水平分流,存在者测量分流的大小;对于TTE显示房水平分流不明显的患者行经食管超声心动图(TEE)检查,观察房间隔卵圆孔的形态以及是否存在房水平分流,存在者测量分流的大小;对于存在房水平分流的患者行c TTE检查,观察左心内显示微气泡的数量及出现微气泡的时间,根据分流量分成0、Ⅰ、Ⅱ、Ⅲ级。结果 TTE检出存在房水平分流27例,TEE检出存在房水平分流11例,无分流13例;c TTE检测存在房水平分流38例中,分流量0级3例、Ⅰ级5例、Ⅱ级21例、Ⅲ级9例。TTE、TEE测量的PFO直径与c TTE检测PFO分流等级间存在明显的相关性(r=0.876,P<0.05)。结论 UCG结合c TTE的应用,可以明确PFO的大小、分流量以及微气泡出现的时间,为临床的诊断和治疗提供参考依据。Objective To investigate value of echocardiography（ UCG） combined with right heart contrast echocardiography（ c TTE）in patent foramen（ PFO）,and to provide a reference for clinical diagnosis and treatment. Methods A retrospective study was performed on 51 patients with clinical suspicion of PFO who were received in The General Hospital of Shenyang Military Command from January 2015 to December 2015. Patients were determined to be the atrial shunt or not by transthoracic echocardiography（ TTE）,and the size of the shunt was measured. When TTE did not significantly show atrial shunt,esophageal echocardiography（ TEE） would be used in patients to observe the morphology in patent foramen ovale and to determine whether the shunt was in atrial level or not,and the size of the shunt was measured;patients who were determined atrial shunt would undergo c TTE,the number of micro bubbles in the left heart and time of emergence of micro bubbles were observed to divide into Grade 0,Ⅰ,Ⅱ and Ⅲ according to the shunt volume.Results Among 51 cases of doubt PFO patients,27 cases of atrial shunt were detected by TTE,11 cases of atrial shunt and 13 cases of non atrial shunt were detected by TEE;among 38 cases of atrial shunt detected by c TTE,there were 3 cases in Grade 0,5 cases in Grade Ⅰ,21 cases in Grade Ⅱ and 9 cases in Grade Ⅲ. There was significant correlation between PFO diameter（ detected by TTE and TEE） and PFO shunt grade（ detected by c TTE）（ r = 0. 876,P〈0. 05）. Conclusion Application of UCG combined with c TTE,can define the PFO size,shunt volume and time of emergence of micro bubbles,which provides a reliable reference for clinical diagnosis and treatment.

关 键 词：卵圆孔未闭 经胸超声心动图 经食管超声心动图 声学造影 

分 类 号：R541.1[医药卫生—心血管疾病]