彩色多普勒超声心动图诊断飞行员下腔静脉瓣过长五例并文献复习  

Five cases of pilots with eustachian valve mecism diagnosed by color Doppler ultrasound cardiogram and literature review

作　　者：郝建华[1] 郭辉[1] 王洋[1] 范晓燕[1] 夏阳[1] 邱衍哲 朱晓全[1] 

机构地区：[1]空军航空医学研究所载人离心机医学训练基地,北京100089

出　　处：《中华航空航天医学杂志》2017年第1期47-51,共5页Chinese Journal of Aerospace Medicine

摘　　要：目的探讨飞行员下腔静脉瓣过长的彩色多普勒超声心动图诊断及临床意义。方法采用彩色多普勒超声心动图诊断5例飞行员下腔静脉瓣过长，观察右心房内过长的下腔静脉瓣形态、位置、活动范围、附着点及对血流动力学的影响；结合相关文献复习，总结下腔静脉瓣过长的分型、诊断、临床意义以及其航空医学鉴定。结果5例下腔静脉瓣过长飞行员的超声心动图示右心房内活动的光带，长35-47mm，宽3-4mm，其一端连于下腔静脉口，另一端延伸游离于右心房内侧壁，即房间隔中部或漂浮近三尖瓣瓣口（其中1例合并有室间隔膜部瘤）；彩色多普勒超声心动图均未见异常血流动力学改变。经航空医学鉴定，5例飞行员均飞行合格。结论超声心动图诊断下腔静脉瓣过长准确、快速、便捷。残存右心房内下腔静脉瓣通常无临床症状，与血栓形成、心律失常及介入治疗中缠绕导丝线等相关。下腔静脉瓣过长飞行员无f临床症状和不良主诉，飞行耐力良好，建议密切观察及定期追踪随访。Objective To discuss the echocardiography diagnosis on the pilots with eustachian valve （EV） mecism and the clinical significance. Methods The eustachian valve mecism in 5 pilots was diagnosed by color Doppler ultrasound cardiogram, and the shape, position, motion, attachment point of the overlong venous sinus valve in right atria were observed and the influences on hemodynamics were discussed. The type, diagnosis, clinic significance and aeromedical determination of EV were concluded by reviewing literature in terms of it. Results There were 5 cases of pilots with EV mecism, and ultrasound cardiogram showed a light ribbon moving in the right atrium which length ranged from 35 to 47 mm and the width ranged from 3 to 4 mm. One side of the ribbon connected with inferior vena cava, and the other side extended to the interior wall of right atrium where the middle of atrial septum and the tricuspid valve annulus located at （one case associated with ventricular septal aneurysm）. There was no hemodynamics change detected by ultrasound cardiogram.Therefore, all 5 pilots were qualified for flight. Conclusions Ultrasound cardiogram is an accurate, rapid and convenient method to diagnose EV mecism. EV remaining in right atria commonly has no clinical manifestation, but associated with thrombosis, arrhythmia, catheter entrapmen in the interventional therapy. Even the pilots with EV usually have no clinic manifestation and no subjective symptoms in flight, and their flight endurance is seemed in good condition. But the close supervision and periodical follow up are still suggested.

关 键 词：腔静脉 下 超声心动描记术 多普勒 彩色 合格鉴定 飞行员 

分 类 号：R856[医药卫生—航空、航天与航海医学]