二维斑点追踪成像技术对不同范围肺切除术后早期患者左心室收缩功能的评估  

Assessment of left ventricular systolic function in early postoperative patients with different range of pneumonectomy by two-dimensional speckle tracking imaging technique

作　　者：王振华 WANG Zhenhua(Department of Ultrasound,Luoyang Centeral Hospital Affiliated to Zhengzhou University,Luoyang,Henan,471000,China)

机构地区：[1]郑州大学附属洛阳中心医院超声科,河南洛阳471000

出　　处：《甘肃中医药大学学报》2021年第4期50-54,共5页Journal of Gansu University of Chinese Medicine

基　　金：洛阳市中心医院孵育计划项目(2018FY-03)。

摘　　要：目的应用二维斑点追踪成像(2D-STI)技术研究肺切除术后1个月患者的左心室收缩功能变化规律。方法选取单侧全肺切除患者17例(P组)、肺叶切除患者45例(L组),分别在患者行肺切除术前、术后1周、术后1个月获取患者的常规超声心动图参数[左心室舒张末期内径(LVEDD)、左心室后壁舒张末厚度(LVPWd)、室间隔舒张末厚度(IVSd)、心率(HR)、每搏输出量(SV)、左心室射血分数(LVEF)],应用2D-STI技术获取左室心尖长轴切面纵向峰值应变(GLPS-LAX)、左室心尖四腔心切面纵向峰值应变(GLPS-A4C)、左室心尖两腔心切面纵向峰值应变(GLPS-A2C)和左室整体纵向峰值应变(LVGLPS),对2组手术前后上述参数进行比较。结果与同组术前比较,P组术后1周及1个月HR均明显升高,L组术后1周HR明显升高,2组术后1周LVEF均明显降低,差异有统计学意义(P<0.05);与同组术后1周比较,2组术后1个月HR均明显降低,LVEF均明显升高,差异有统计学意义(P<0.05);术后1周及1个月P组HR均明显高于同期L组,2组比较差异有统计学意义(P<0.05)。与同组术前比较,2组术后1周GLPS-LAX、GLPS-A4C、GLPS-A2C、LVGLPS参数均明显降低,差异有统计学意义(P<0.05);与同组术后1周比较,2组术后1个月GLPS-LAX、GLPS-A4C、GLPS-A2C、LVGLPS参数均明显升高,差异有统计学意义(P<0.05);术后1周P组GLPS-LAX、GLPS-A4C、GLPS-A2C、LVGLPS参数明显低于同期L组,差异均有统计学意义(P<0.05)。结论 2D-STI技术可早期发现肺切除术后患者的左心室收缩功能变化;肺切除术后患者会出现左心室收缩功能损伤,且单侧全肺切除术对患者左心室收缩功能的影响较肺叶切除术大。Objective To study the change rule of left ventricular systolic function in postoperative patients after different range of pneumonectomy for 1 month by two-dimensional speckle tracing imaging( 2 D-STI) technique.Methods Seventeen patients with unilateral total pneumonectomy( group P) and forty-five patients with pulmonary lobectomy( group L) were chosen,the routine echocardiogram parameters [left ventricular end diastolic diameter( LVEDD),left ventricular posterior wall end-diastolic thickness( LVPWd),interventricular septal end-diastolic thickness( IVSd),heart rate( HR),stroke volume( SV),left ventricular ejection fraction( LVEF) ] were obtained before operation,1 week and 1 month after pneumonectomy,global longitudinal peak strain of left ventricular apical long axis( GLPS-LAX) section,global longitudinal peak strain of left ventricular apical 4-chamber( GLPS-A4 C)section,global longitudinal peak strain of left ventricular apical 2-chamber( GLPS-A2 C) section,and left ventricular global longitudinal peak strain( LVGLPS) were obtained using 2 D-STI technique,and the above-mentioned parameters were compared between the 2 groups before and after operation. Results Compared with the same group before operation,HR in group P increased significantly at 1 week and 1 month after operation,HR in group L increased significantly at 1 week after operation,and LVEF in both groups decreased significantly at 1 week after operation,and the difference was statistically significant( P <0.05);Compared with 1 week after operation in the same group,HR decreased significantly and LVEF increased significantly in both groups at 1 month after operation,and the difference was statistically significant( P<0.05);1 week and 1 month after operation,HR of group P was significantly higher than that of group L,and the difference was statistically significant between the 2 groups( P <0.05). Compared with the same group before operation,the parameters of GLPS-LAX,GLPS-A4 C,GLPS-A2 C and LVGLPS significantly decreased in the 2 groups at 1 week a

关 键 词：肺切除术 二维斑点追踪成像技术 超声心动图 二维应变分析 参数 左心室 收缩功能 

分 类 号：R256.2[医药卫生—中医内科学]