超声心动图和心血管造影在儿童先天性心脏病介入治疗中的应用  

Application of echocardiography and angiocardiography in interventional treatment for children congenital heart disease

作　　者：董楠 孙景巍[1] 田净忆 李加晨 DONG Nan;SUN Jing-wei;TIAN Jing-yi;LI Jia-chen(Department of Ultrasound,Bengbu First People's Hospital,Bengbu,Anhui 233000,China)

机构地区：[1]蚌埠市第一人民医院超声科,安徽蚌埠233000

出　　处：《中国临床研究》2020年第11期1512-1515,共4页Chinese Journal of Clinical Research

摘　　要：目的探讨经胸超声心动图(TTE)和心血管造影(ACG)在皖北市级医院开展儿童先天性心脏病(CHD)介入治疗中的应用评估。方法选取2017年4月至2019年12月收治的62例CHD介入封堵术患儿为研究对象,包括房间隔缺损(ASD)11例,室间隔缺损(VSD)23例,动脉导管未闭(PDA)28例。所有CHD患儿在放置封堵器前均行TTE与ACG评估缺损位置和大小,对符合介入治疗指征的患者行介入治疗,释放后再通过TTE与ACG判断封堵器位置形态及是否存在残余分流。结果TTE与ACG检查对三种CHD的术前诊断准确率均为100%,TTE测量的PDA、VSD、ASD内径分别为(3.61±0.63)mm、(4.25±0.59)mm、(5.63±0.86)mm,均显著大于相应的ACG测量结果(3.26±0.65)mm、(4.03±0.58)mm、(4.89±0.80)mm(P<0.05,P<0.01)。TTE和ACG均显示术后封堵器位置固定且无残余反流,TTE在封堵器对周围组织影响的显示方面明显优于ACG。结论TTE对于儿童CHD介入治疗的术前诊断与术后评估的应用优势大于ACG,但ACG在术中确定病变大小及指导封堵器选择的准确性方面高于TTE。Objective To evaluate the value of transthoracic echocardiography(TTE)and angiocardiography(ACG)in the interventional treatment of children with congenital heart disease(CHD)in a Wanbei municipal Hospital.Methods Sixty-two CHD children undergoing transcatheter interventional occlusion from April 2017 to December 2019 were enrolled as the research subjects,including 11 cases of atrial septal defect(ASD),23 cases of ventricular septal defect(VSD)and 28 cases of patent ductus arteriosus(PDA).TTE and ACG were applied to assess the location and size of the defect before placement of the occluder,and the interventional therapy was performed in the patients who were eligible for intervention.After the occluder was released,TTE and ACG were used to determine the location and shape of occluder and whether there was residual shunt.Results The preoperative diagnostic accuracy of TTE and ACG was 100%for three kinds of CHD.The inner diameters of PDA,VSD and ASD measured by TTE were(3.61±0.63)mm,(4.25±0.59)mm,(5.63±0.86)mm,respectively,which were significantly high than the corresponding results[(3.26±0.65)mm,(4.03±0.58)mm,(4.89±0.80)mm]measured by ACG(P<0.05,P<0.01).Both TTE and ACG showed that the positions of occluder were fixed,and there were no residual shunt.TTE was superior to ACG in showing the influence of the device on the surrounding tissue.Conclusion TTE is superior to ACG in preoperative diagnosis and postoperative evaluation of interventional treatment of CHD in children,while ACG is superior to TTE in determining the defect size and guiding the selection of occluder.

关 键 词：先天性心脏病 儿童 经胸超声心动图 心血管造影 介入治疗 房间隔缺损 室间隔缺损 动脉导管未闭 

分 类 号：R725.4[医药卫生—儿科]