超声心动图对儿童漏斗胸手术右心室随访评价  

Echocardiography in Evaluating the Right Ventricle in Children with Funnel Chest Surgery

作　　者：闵杰青[1] 田锦润 洪伟[1] 魏骊铮 曹彦洁 王华平 MIN Jie-qing;TIAN Jin-run;HONG Wei;WEI Li-zheng;CAO Yan-jie;WANG Hua-pin(Dept. of Echocardiography,Kunming Children’s Hospital,Kunming Yunnan 650028;The Library ofKunming Medical University,Kunming Yunnan 650500,China)

机构地区：[1]昆明市儿童医院心功能科,云南昆明650028 [2]昆明医科大学图书馆,云南昆明650500

出　　处：《昆明医科大学学报》2019年第3期116-119,共4页Journal of Kunming Medical University

基　　金：昆明市西山区科技计划项目(西科字31号)

摘　　要：目的分别用超声心动图测量、二维斑点追踪技术测定三尖瓣环位移以及CT检查的haller指数(HI)对漏斗胸术前、术后半年患儿进行检查随访,探讨在临床上应用超声技术评估漏斗胸患儿右心室收缩功能变化的应用价值。方法选取自2017年3月至2018年8月在昆明市儿童院确诊漏斗胸并进行手术的患儿48例。超声心动图分别测量M型右心室大小(RVD)、M型三尖瓣环位(TAPSE)、三尖瓣环径(TVAD)、应用二维斑点追踪技术测量三尖瓣隔瓣附着点(TMAD1)、三尖瓣前瓣附着点(TMAD2)、三尖瓣环连线中点收缩期峰值位移(TMADm)以及右心室纵向缩短分数(TMAD%)。胸部CT测量HI。结果术前与术后半年RVD、TAPSE、TVAD及HI,差异有统计学意义(P <0.001)。各项指标术后半年比术前增高。TMAD%有统计学差异(P <0.05)。TMAD1、TMAD2、TMADm术后半年较术前有所增加,差异无统计学意义(P> 0.05)。结论常规超声心动图结合二维斑点追踪技术对漏斗胸术前术后进行心脏结构以及功能的评估是一种可靠的方法,运用多种指标一起进行综合评估,为漏斗胸的心脏压迫情况以及右心室收缩功能损害情况提供客观依据,可以用于漏斗胸患儿的治疗随访过程。Objective To explore the application value of ultrasound technology in clinical evaluation of right ventricular systolic function in children with funnel chest through using echocardiography and two-dimensional spot tracking, haller index(HI) of tricuspid ring displacement and CT examination to follow up patients before and six months after operation. Methods From March 2017 to August 2018, we selected 48 cases of children who were diagnosed with funnel chest and operated in our hospital from March 2017 to August 2018.Echocardiography measured M type(RVD), right ventricular size M type tricuspid ring(TAPSE), tricuspid ring diameter(TVAD), the application of two-dimensional speckle tracking technology measure the tricuspid valve attachment points(TMAD1), tricuspid valve attachment points before(TMAD2), tricuspid ring attachment midpoint displacement(TMADm) and right ventricular systolic peak longitudinal shortening fraction(TMAD %). Chest CT measures HI. Results There were statistically significant differences in RVD, TAPSE, TVAD and HI between preoperative and postoperative six months(P<0.001).The indexes were increased six months after operation. There was a statistical difference in TMAD%(P<0.05).TMAD1, TMAD2, and TMADm increased in the six months after operation, but there was no statistical difference(P >0.05). Conclusions Conventional echocardiography combined with two-dimensional speckle tracking technique is a reliable method to evaluate the cardiac structure and function before and after funnel chest surgery. It can provide objective basis for the cardiac compression of funnel chest and the damage of right ventricular systolic function. It can be used in the follow-up process of children with funnel chest.

关 键 词：漏斗胸 三尖瓣环位移 斑点追踪 右心室收缩功能 超声心动图 

分 类 号：R725.4[医药卫生—儿科]