综合超声心动图在儿童主动脉瓣畸形Ozaki手术中的应用价值研究  

Study on the value of integrated echocardiography in Ozaki operation in children with aortic valve malformation

作　　者：张志芳[1] 田嘉禾 张玉奇[1] 张海波[3] 刘怡青 胡仁杰 ZHANG Zhifang;TIAN Jiahe;ZHANG Yuqi;ZHANG Haibo;LIU Yiqing;HU Renjie(Department of Pediatric Cardiology,Shanghai Children’s Medical Center,Shanghai Jiaotong University School of Medicine,Shanghai 200127,P.R.China;Second Grade in Shanghai Shibei High School,Shanghai 200070,P.R.China;Department of Cardiac Surgery,Shanghai Children’s Medical Center,Shanghai Jiaotong University School of Medicine,Shanghai 200127,P.R.China)

机构地区：[1]上海交通大学医学院附属上海儿童医学中心心内科,上海200127 [2]上海市市北中学高二年级,上海200070 [3]上海交通大学医学院附属上海儿童医学中心心外科,上海200127

出　　处：《医学影像学杂志》2019年第2期233-237,共5页Journal of Medical Imaging

基　　金：上海申康医院发展中心临床科技创新项目(编号:SHDC22015019)

摘　　要：目的评价经胸二维超声心动图(2DE)、经食道超声心动图(TEE)、经胸三维超声心动图(3DE)在儿童主动脉瓣病变Ozaki手术中的应用价值。方法回顾性分析7例Ozaki手术患者的2DE、TEE、3DE资料特征。结果 7例患者术前均行2DE及3DE检查,与手术结果对比,超声诊断正确7例,占100%;合并单支冠状动脉2例、冠状动脉肺动脉瘘1例,超声检查均漏诊。7例均行术中TEE检查,术后3个月2DE复查,主动脉反流束宽明显减轻(0.64±0.25)cm vs (0.22±0.04)cm,(P<0.01)、左心室舒张末期内径明显减小(5.69±0.45)cm vs (4.50±0.83)cm,(P<0.01)。结论2DE、3DE术前可以显示主动脉瓣的数目、大小、狭窄及反流的程度,比较准确地诊断主动脉瓣病变,但容易漏诊合并的冠状动脉畸形;TEE在术中即刻效果判断、2DE在术后随访中起重要作用,是儿童主动脉瓣病变Ozaki手术安全、有效的监测方法。Objective To evaluate the value of integrated echocardiography in Ozaki operation in children with aortic valve malformation. Methods Ozaki operation was performed in 7 children with aortic valve malformation. Transthoracic 2-dimensional echocardiography (2DE), Transthoracic 3-dimensional echocardiography (3DE) and transesophageal echocardiography (TEE) were performed before and after Ozaki operation. Results Compared with the surgical findings, aortic valve malformation was diagnosed correctly in 7 cases (100%) by 2DE and 3DE, 2 cases with single coronary artery and 1 case with fistula between coronary artery and pulmonary artery were miss diagnosed. TEE and 2DE were performed during and 3 months later of Ozaki operation, vena contracta width of aortic valve regurgitation was reduced significantly (0.64±0.25) cm vs (0.22±0.04) cm,( P <0.01). Conclusion Integrated echocardiography could clearly demonstrate the number, size of aortic valve anomalies. It was valuable for patients selection before the operation, and evaluating the operative effects and was a safe and effective guidance technique. It was prone to be miss diagnosed for associated coronary artery anomaly.

关 键 词：超声心动图 主动脉瓣病变 Ozaki手术 

分 类 号：R541[医药卫生—心血管疾病] R445.1[医药卫生—内科学]