经胸超声心动图对心脏创伤诊断价值  

The Value of Transthoracic Echocardiography in the Diagnosis of Cardiac Trauma

作　　者：王清木[1] 刘慧兰[1] 洪丹丹[1] 刘建平[1] 颜如玉[1] 

机构地区：[1]福建医科大学附属泉州第一医院超声心动图室,福建省泉州市362000

出　　处：《中国超声医学杂志》2017年第9期843-845,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的本研究旨在评估经胸超声心动图在心脏创伤中的应用价值。方法回顾性分析15例心脏创伤患者的临床资料和超声心动图影像资料,超声诊断与手术结果进行比较。结果超声心动图检出心包积液13例,其中9例伴血凝块形成,右室侧壁穿孔1例,三尖瓣腱索断裂伴重度三尖瓣反流1例,二尖瓣腱索断裂伴后叶穿孔1例,室间隔穿孔2例,金属异物存留1例,主动脉右冠瓣脱垂1例,右冠窦-右室分流1例。超声心动图对瓣膜损伤、室间隔穿孔、心包积液及异物存留的诊断与手术结果完全符合。漏诊右室壁穿孔4例,右室挫伤2例,右房壁穿孔2例,升主动脉近端壁血肿1例。结论超声心动图检查是诊断心脏创伤快捷、有效的方法,且能在床旁进行急诊检查,对诊断心脏创伤诊断具有重要临床价值,并指导临床治疗。Objective To evaluate the value of transthoracic echocardiography in cardiac trauma. Methods The clinical data and echocardiographic imaging data of 15 patients with cardiac trauma were analyzed retrospectively. Ech- ocardiography diagnosis and surgical results were compared subsequently. Results Pericardial effusion was found in 13 cases by echocardiography, 9 of them were combined with the formation of blood clots. Meanwhile, 1 case showed perforation of the right ventricular lateral wall, 1 case demonstrated tricuspid chordae tendineae rupture with severe tricuspid regurgitation, 1 case was reported to have rupture of mitral chordae tendineae combined with perforation of the posterior mitral valve, 2 cases with perforation of ventricular septum, 1 case with retained metal foreign body, 1 case showing right coronary cusp prolapse, and 1 case revealing right coronary sinus to right ventricular shunt. Echo- cardiographic diagnosis of valvular injury, perforation of ventricular septum, pericardial effusion, and foreign body re- tention was consistent with the surgical results. In addition, missed diagnosis cases in the study included 6 cases of right ventricular wall perforation or contusion, 2 cases of right atrial wall perforation, and 1 case of hematoma invol- ving the proximal ascending aorta wall. Conclusions Echocardiography is a rapid and effective diagnostic method, which can be used in the diagnosis of traumatic cardiac injury and for emergency examination bedside. Echocardio- graphy is of great clinical value in the diagnosis of cardiac trauma and can help to guide therapy.

关 键 词：超声心动描记术 心脏创伤 诊断 

分 类 号：R540.45[医药卫生—心血管疾病] R654.2[医药卫生—内科学]