超声心动图对室间隔完整型肺动脉闭锁的诊断价值  

Diagnostic Value of Echocardiography on Pulmonary Atresia with Intact Ventricular Septum

作　　者：余海莹[1] 莫莉[2] 郑春华[3] 包敏[3] 任军[3] 曹爱梅[3] 刘波[3] YU Hai-ying;MO Li;ZHENG Chun-hua;BAO Min;REN Jun;CAO Ai-mei;LIU Bo(Department of Ultrasonography,the People's Hospital of Beihai,Beihai 536000,China;Department of Ultrasonography,Maternal and Child Care Service Center of Anshun,Anshun 561000,China;Department of Cardiology,Children's Hospital Affiliated to Capital Institute of Pediatrics,Beijing 100020,China)

机构地区：[1]广西壮族自治区北海市人民医院超声科,536000 [2]贵州省安顺市妇幼保健院超声科,561000 [3]首都儿科研究所附属儿童医院心内科,北京市100020

出　　处：《实用心脑肺血管病杂志》2018年第9期79-81,共3页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的分析超声心动图对室间隔完整型肺动脉闭锁(PAIVS)的诊断价值。方法选取2013年9月—2018年5月广西北海人民医院、贵州安顺妇幼保健医院及首都儿科研究所附属儿童医院收治的PAIVS患儿25例,均进行超声心动图检查,分析PAIVS检出率及其表现。结果 (1)超声心动图检出PAIVS患儿23例,检出率为92.0%;漏诊2例,漏诊率为8.0%。25例患儿室间隔均完整,其中经心外科手术确诊19例,经心血管造影确诊4例,经心脏CT确诊3例。(2)肺动脉瓣膜性闭锁20例,肺动脉瓣消失及主肺动脉近端闭锁5例,其中"右心室依赖型"冠状动脉循环3例。(3)右心室发育不良者12例,占48.0%。(4)合并房间隔缺损或卵圆孔未闭25例(占100.0%),右房室瓣反流23例(占92.0%),动脉导管未闭18例(占72.0%),右房室瓣发育不良10例(占40.0%),体肺侧支7例(占28.0%),右房室瓣闭锁2例(占8.0%)。结论超声心动图对PAIVS具有较高的诊断价值;PAIVS主要类型为肺动脉瓣膜性闭锁,患儿常伴有右心室发育不良、房间隔缺损或卵圆孔未闭、右房室瓣返流、动脉导管未闭等。Objective To analyze the diagnostic value of echocardiography on pulmonary atresia with intact ventricular septum(PAIVS).Methods From September 2013 to May 2018,a total of 25 children with PAIVS were selected in the People's Hospital of Beihai,Maternal and Child Care Service Center of Anshun,Children's Hospital Affiliated to Capital Institute of Pediatrics,all of them received echocardiographic examination,detection rate of PAIVS and the diagnostic features were analyzed.Results (1)According to echocardiographic examination results,the detection rate of PAIVS was 92.0%(23/25),the rate of missed diagnosis was 8.0%(2/25).All of the 25 children confirmed as intact ventricular septum,thereinto 19 cases confirmed by cardiac surgery,4 cases confirmed by cardioangiography,3 cases confirmed by cardiac CT examination.(2)Of the 25 children,20 cases performed as valvular atresia of pulmonary artery,5 cases performed as disappearance of pulmonary valve and proximal atresia of main pulmonary artery,in which 3 cases performed as right ventricular dependent coronary circulation.(3)Of the 25 children,12 cases found hypoplasia of right ventricular cavity(accounting for 48.0%).(4)Complications:all of the 25 cases complicated with atrial septal defect or patent foramen ovale(accounting for 100.0%),23 cases complicated with tricuspid regurgitation(accounting for 92.0%),18 cases complicated with patent ductus arteriosus(accounting for 72.0%),10 cases complicated with dysplasia of right atrioventricular valve(accounting fro 40.0%),7 cases complicated with major aortopulmonary collateral arteries(accounting for 28.0%),2 cases complicated with right atrioventricular valve atresia(accounting for 8.0%).Conclusion Echocardiography has relatively high diagnostic value on PAIVS;valvular atresia of pulmonary artery is the main type of PAIVS,usually complicated with hypoplasia of right ventricular cavity,atrial septal defect or patent foramen ovale,tricuspid regurgitation,patent ductus arteriosus and so on.

关 键 词：室间隔完整型肺动脉闭锁 超声心动描记术 诊断 

分 类 号：R541.1[医药卫生—心血管疾病]