体外膜肺氧合治疗中超声心动图指导房间隔造口术的应用价值  

The monitoring value of echocardiography for atrial septostomy during the treatment of extracorporeal membrane oxygenation

作　　者：余正春[1] 马小静[1] 刘燕[2] 夏娟[1] Yu Zhengchun;Ma Xiaojing;Liu Yan;Xia Juan(Department of Ultrasonography,Wuhan Asia Heart Hospital,Wuhan 430022,China;Department of Extracorporeal Circulation,Wuhan Asia Heart Hospital,Wuhan 430022,China)

机构地区：[1]武汉亚洲心脏病医院超声科,430022 [2]武汉亚洲心脏病医院灌注科,430022

出　　处：《中华超声影像学杂志》2021年第5期388-391,共4页Chinese Journal of Ultrasonography

基　　金：武汉市卫计委课题(WX15A01)。

摘　　要：目的探讨超声心动图对体外膜肺氧合(ECMO)治疗时房间隔造口术的监测价值。方法选取2017年1月至2019年12月于武汉亚洲心脏病医院接受ECMO治疗并行房间隔造口术的患者16例。应用超声心动图监测房间隔造口术中及术后每日造口内径大小、房水平分流方向、三尖瓣反流程度及估测肺动脉压力的变化。结果16例患者造口内径每日监测无明显变化(变异系数范围0.86%~4.77%);16例患者房水平分流方向均由右房至左房分流为主向左房至右房分流变化;通过三尖瓣反流速度压差估测的肺动脉压力降低(变异系数范围14.70%~32.13%)。结论房间隔造口术是ECMO治疗过程中缓解患者右心压力、改善右心功能的有效措施。超声心动图监测可为治疗的顺利进行提供帮助。Objective To investigate the monitoring value of echocardiography for atrial septostomy during the treatment of extracorporeal membrane oxygenation(ECMO).Methods Sixteen patients underwent atrial septostomy during the treatment of ECMO in Wuhan Asia Heart Hospital from Jan.2017 to Dec.2019 were included.The diameter of the ostomy,the direction of interatrial shunt,the tricuspid regurgitation degree and the pulmonary artery pressure were measured by echocardiography daily after atrial septostomy.Results There were no significant differences in the diameter of the ostomy in 16 patients(the range of coefficient of variation 0.86%-4.77%).The direction of interatrial shunt changed gradually from right-left atrial shunt to left-right atrial shunt.Pulmonary arterial pressure decreased gradually(the range of coefficient of variation 14.70%-32.13%)as estimated by tricuspid regurgitation pressure gradient.Conclusions Atrial septostomy is an effective measure to relieve right heart pressure and improve right heart function in patients with ECMO.The echocardiography can be helpful for the monitoring of atrial septostomy.

关 键 词：超声心动描记术 体外膜肺氧合 房间隔造口术 

分 类 号：R654.2[医药卫生—外科学]