经胸超声心动图对二尖瓣腱索断裂的诊断价值  

Diagnostic value of transthoracic echocardiography in mitral chordae tendinae rupture

作　　者：吕水萍 覃莉丽 王开权 LV Shui-ping;QIN Li-li;WANG Kai-quan(Ultrasound Imaging Departement II,Enshi Tujia and Miao Autonomous Prefecture Central Hospital,Enshi 445000,Hubei,CHINA)

机构地区：[1]恩施土家族苗族自治州中心医院超声影像二科,湖北恩施445000

出　　处：《海南医学》2022年第22期2948-2951,共4页Hainan Medical Journal

摘　　要：目的评估经胸超声心动图(TTE)诊断二尖瓣腱索断裂(MCTR)的准确性及临床价值。方法选取2016年1月至2021年10月恩施土家族苗族自治州中心医院收治的44例MCTR患者为研究对象,所有患者均经TTE检查及手术治疗,以术中结果为金标准。将TTE检查结果与术中所见进行比较,分析TTE与手术结果的符合率以及TTE诊断MCTR的误诊率。结果TTE诊断44例MCTR患者,前叶腱索断裂20例,后叶腱索断裂24例,断裂腱索的长度多数(72.7%)<1 cm,少数(27.3%)≥1 cm,断裂腱索长度二者比较差异具有统计学意义(P<0.05);44例MCTR患者中经手术证实MCTR 39例,前叶腱索断裂15例,后叶腱索断裂23例,前后叶腱索断裂1例,前叶、后叶腱索断裂之间比较差异无统计学意义(P>0.05);TTE诊断MCTR的符合率为88.6%,误诊率为11.4%;诊断前叶腱索断裂的符合率为75%,误诊率为25%;诊断后叶腱索断裂的符合率为87.5%,误诊率为12.5%。结论TTE对诊断MCTR有较高的准确性,能为外科医师拟定手术方案提供有力帮助,在临床诊断中具有一定的应用价值。Objective To evaluate the accuracy and clinical value of transthoracic echocardiography(TTE)in the diagnosis of mitral chordae tendinae rupture(MCTR).Methods A total of 44 patients with MCTR admitted to Enshi Tujia and Miao Autonomous Prefecture Central Hospital from January 2016 to October 2021 were selected as the research objects.All patients were examined by TTE and treated surgically.The intraoperative results were taken as the gold standard.The TTE examination results and the intraoperative findings were compared,and the coincidence rate of TTE and surgical results and the misdiagnosis rate of TTE in diagnosing MCTR were analyzed.Results Among the 44 patients with MCTR diagnosed by TTE,20 were found with rupture of the anterior leaflet,and 24 with rupture of the posterior leaflet.Most of the ruptured tendinae(72.7%)were less than 1 cm in length,and a few(27.3%)were not less than than 1 cm,with statistically significant difference(P<0.05).Among the 44 patients,39 were confirmed to be MCTR by surgery,including 15 with rupture of the anterior leaflet,23 with rupture of the posterior leaflet,1 with rupture of both leaflets;there was no statistically significant difference between the rupture of the anterior and posterior tendons(P>0.05).The coincidence rate of diagnosing MCTR by TTE was 88.6%,and the misdiagnosis rate was 11.4%;the coincidence rate of diagnosing the rupture of anterior leaflet was 75%,and the misdiagnosis rate was 25%;the coincidence rate of diagnosing the rupture of posterior leaflet was 87.5%,and the misdiagnosis rate was 12.5%.Conclusion TTE has a high diagnostic accuracy for diagnosing MCTR,which can provide strong help for surgeons to formulate surgical plans and has a certain application value in clinical diagnosis.

关 键 词：二尖瓣腱索断裂 二尖瓣关闭不全 经胸超声心动图 外科手术 诊断价值 

分 类 号：R542.51[医药卫生—心血管疾病]