新生儿室间隔缺损超声心动图随访研究  

Follow-up study of neonatal ventricular septal defect with transthoracic echocardiography

作　　者：浦雪[1] 熊毅[1] 李仁丽[1] 宋丹阳[1] 王丹[1] PU Xue;XIONG Yi;LI Ren-li;SONG Dan-yang;WANG Dan(Department of Ultrasonography,Shenyang Women′s and Children′s Hospital,Shenyang 110011,China)

机构地区：[1]沈阳市妇婴医院超声科,辽宁沈阳110011

出　　处：《临床军医杂志》2021年第10期1100-1102,共3页Clinical Journal of Medical Officers

基　　金：辽宁省科学技术基金(20180550521)。

摘　　要：目的通过超声心动图(TTE)随访观察新生儿期室间隔缺损的变化情况,为非自愈室间隔缺损患儿临床治疗时机的选择提供参考。方法选取自2016年1月至2018年12月于沈阳市妇婴医院出生后1~3 d行TTE检查,明确为单纯性室间隔缺损的53例患儿为研究对象。每6个月行TTE监测,明确患儿的室间隔缺损的大小、位置、形态及心腔内径的变化,随访至24个月。结果TTE检查结果显示,肌部室间隔缺损36例(67.9%),膜部室间隔缺损15例(28.3%),干下型室间隔缺损2例(3.8%)。随访发现,手术治疗2例(3.8%,2/53),为干下型室间隔缺损;自然闭合38例(74.5%,38/51),未闭合13例(25.5%,13/51);无死亡及失访患儿。肌部室间隔缺损自然闭合率为83.3%(30/36),高于其他部位缺损的53.3%(8/15);室间隔缺损<4 mm的自然闭合率为84.2%(32/38),高于室间隔缺损>4 mm的46.2%(6/13);膜周部室间隔缺损合并膨出瘤自然闭合率为46.7%(7/15),高于单纯膜周部室间隔缺损的6.7%(1/15);差异均有统计学意义(P<0.05)。出生后6、12、18、24个月,患儿左心房、左心室内径均大于出生后1~3 d,差异有统计学意义(P<0.05)。结论对于TTE显示室间隔缺损小、位置好,心腔变化不大,有自然闭合可能的患儿,应定期随访观察;对于室间隔缺损大、位置差,心腔增大明显的患儿,应及早手术治疗。Objective Transthoracic echocardiography(TTE)follow-up was used to observe the changes of ventricular septal defect(VSD)in neonates,providing reference for the selection of therapeutic opportunities for children with non-self-healing ventricular septal defect.Methods A total of 53 children with simple VSD were selected as the study subjects after 1 to 3 days of postnatal echocardiography in Shenyang Women′s and Children′s Hospital from January 2016 to December 2018.TTE monitoring was performed every 6 months to determine the size,location,morphology and changes of ventricular septal defect,followed up to 24 months.Results The results of TTE examination showed that 36 cases(67.9%)had muscular ventricular septal defects,15 cases(28.3%)had membranous ventricular septal defects,and 2 cases(3.8%)had subdry ventricular septal defects.Follow-up showed that 2 cases(3.8%,2/53)were treated by operation,which was subdry ventricular septal defect.There were 38 cases(74.5%,38/51)of natural closure and 13 cases(25.5%,13/51)of unclosed closure.There was no death or loss of follow-up.The natural closure rate of ventricular septal defect was 83.3%(30/36),was higher than that of other defects(53.3%,8/15).The natural closure rate of ventricular septal defects smaller than 4 millimeters was 84.2%(32/38),higher than that of ventricular septal defects larger than 4 millimeters(46.2%,6/13).The natural closure rate of perimemmal ventricular septal defect with tumor was 46.7%(7/15),which was higher than that of perimemmal ventricular septal defect alone(6.7%),the differences were statistically significant(P<0.05).At 6,12,18 and 24 months after birth,the inner diameter of left atrium and left ventricle was larger than that of 1 to 3 days after birth,with statistical significance(P<0.05).Conclusion Regular follow-up observation should be conducted for children with small ventricular septal defect,good location,little change of heart cavity and possibility of natural closure as shown by TTE.For children with large ventricular septal def

关 键 词：新生儿 室间隔缺损 超声心动图 随访 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]