经胸超声心动图评价成人房间隔大缺损合并三尖瓣反流行房间隔缺损封堵术的疗效  

Evaluation of the efficacy of atrial septal defect occlusion in adult patients with huge atrial septal defect complicated with tricuspid regurgitation through transthoracic echocardiography

作　　者：罗雪清[1] 郭盛兰 Luo Xueqing;Guo Shenglan(Department of Ultrasonography,Affiliated Hospital of Youjiang University for Nationalities,Baise 533000,Guangxi,China)

机构地区：[1]右江民族医学院附属医院超声科,广西百色533000

出　　处：《右江民族医学院学报》2018年第5期462-465,共4页Journal of Youjiang Medical University for Nationalities

摘　　要：目的探讨成人房间隔大缺损(ASD)合并三尖瓣反流(TR)患者房间隔缺损封堵术(ASDO)前、后TR的变化情况,为ASDO术后疗效分析及预后评估提供临床依据。方法回顾性分析204例成功行ASDO的成人大ASD患者封堵前、后TR情况。对所有患者封堵术前与术后1dTR量进行比较,分析封堵术后1dTR下降情况;对其中109例有术后1年完整随访资料的患者根据术前TR量(以10ml为界值)分成Ⅰ组、Ⅱ组,通过对比术前与术后1d、1个月、3个月、6个月、12个月各时间点的TR量,以了解术后近中期TR缓解情况。结果 204例患者封堵术前与术后1dTR量比较差异有统计学意义(P <0.01);109例患者封堵术前、后不同时间点的TR量比较差异有统计学意义,H值分别为158.000和100.421,均为P <0.001。封堵术后各时间点两组间TR量比较差异有统计意义(H=61.545,P <0.001),术后1d即明显下降,术后3个月趋于平稳,近中期随访TR恢复情况良好。结论成人大ASD合并TR患者经胸超声心动图(TTE)能准确定量患者TR情况,术前TR量与术后TR的缓解有关,TR在ASDO术后得到明显改善。Objective To explore the changes of tricuspid regurgitation(TR)in adult patients with huge atrial septal defect(ASD)combined with tricuspid regurgitation(TR)befor and after atrial septal defect occlusion(ASDO),and to provide clinical evidences for the evaluation of postoperative efficacy and prognosis analysis after ASDO. Methods Retrospective analysis of TR befor and after ASDO in 204 adult patients with ASD who underwent ASDO successfully was performed.The volume of TR in all patients before ASDO was compared with that at the first day after ASDO,and the TR decrease volume at the first day after ASDO was analyzed.According to the quantity of preoperative TR(critical value is 10 ml),109 cases of patients with postoperative 1 year follow-up data were divided into groupⅠ(TR volume≤10 ml)and groupⅡ(TR volume>10 ml).The volume of TR before ASDO was compared with the volume of TR at the time points of 1 day,1 month,3 months,6 months and 1 year after ASDO to understand the recent and mid-term remission of TR after surgery. Results The comparison of TR in 204 patients before ASDO with the first day after ASDO showed statistically significant differences(P<0.01).There were statistically significant differences in TR of 109 patients before ASDO and at different time points after ASDO,H values were 158.000 and 100.421 respectively(both were P<0.001).There were significant differences in TR between the two groups at each time point after ASDO(H=61.545,P<0.001),the volume of TR obviously decreased 1 day after ASDO and became stable 3 months after ASDO.The remission of TR in the recent and mid-term follow-up was good. Conclusion Transthoracic echocardiography(TTE)can accurately quantify the TR in adult patients with large ASD complicated with TR.Preoperative TR is related to the remission of TR after surgery,and TR is significantly improved after ASDO.

关 键 词：超声心动图 房间隔缺损封堵术 三尖瓣闭锁不全 

分 类 号：R541.1[医药卫生—心血管疾病] R542.43[医药卫生—内科学]