先天性上肢畸形合并心脏结构异常超声应用分析  

Application Value of Ultrasound in Congenital Upper Extremity Malformations Combined with Cardiac Structural Abnormalities

作　　者：张若冰 于静淼 曹燚 高莉 何靖楠 陈涛 Zhang Ruobing;Yu Jingmiao;Cao Yi;Gao Li;He Jingnan;Chen Tao(Department of Ultrasound,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China)

机构地区：[1]首都医科大学附属北京积水潭医院超声科,北京市100035

出　　处：《中国超声医学杂志》2024年第6期660-663,共4页Chinese Journal of Ultrasound in Medicine

基　　金：北京市医院管理中心第三期“扬帆”计划临床技术创新项目(No.YGLX202319)。

摘　　要：目的 分析先天性上肢畸形与心脏结构异常的相关性。方法 回顾性分析因先天性上肢畸形行外科手术治疗患者的病历资料、超声心动图图像等。结果 回顾性分析1 651例先天性上肢畸形患者的资料,男女比例为1.67∶1,最大年龄27岁,最小年龄5个月。单纯右侧上肢发育畸形752例,单纯左侧上肢发育畸形452例,双侧上肢畸形447例。合并心脏结构异常230例(占总数13.9%),以卵圆孔未闭最常见,其次为房间隔缺损。合并其他系统畸形155例,以足趾畸形最常见。不同类型先天性上肢畸形合并心脏结构异常比例不同,拇指发育不良合并心脏畸形病例数最多(92例),患病率为30.5%,桡侧列发育不良10例,患病率为30.3%,多指89例,患病率为10.9%。结论 上肢畸形患者合并心脏结构异常发病率较高,术前超声心动图检查有助于发现伴发的心脏结构异常,以协助临床规避手术及麻醉的潜在风险。Objective The study is aimed to analyze the correlation between congenital upper extremity malfor-mations and cardiac structural abnormalities.Methods Patients who underwent surgical treatment for congenital up-per extremity malformations were retrospectively enrolled and analyzed from their medical records,and echocardio-graphy images.Results A retrospective analysis was performed in 1651 patients diagnosed with congenital upper ex-tremity malformations.The male to female ratio of patients was 1.67:1,with the maximum age of 27 years and the minimum age of 5 months old.There were 752 cases of right upper extremity malformation,452 cases of left upper extremity malformation,and 447 cases of bilateral upper extremity malformation.A total of 230 cases(13.9% of the total)had combined cardiac structural abnormalities,with patent foramen ovale being the most common,followed by atrial septal defect.A total of 155 cases were complicated with other system malformations,with toe malformations being the most common.The proportion of congenital upper extremity malformations combined with cardiac structural abnormalities varies among different types.Thumb hypoplasia had the highest number of cases with cardiac malforma-tions,with 92 cases involved,corresponding to a prevalence rate of 30.5%.Ten cases were found in patients with radial lateral dysplasia,a prevalence rate being 30.3%,and 89 cases were identified in patients with polydactyly,a prevalence rate being 10.9%.Conclusions The incidence rate of cardiac structural abnormalities in patients with upper extremity malformations is high.Preoperative echocardiography is helpful to find the concomitant cardiac structural abnormalities and to help avoid the potential risks of surgery and anesthesia.

关 键 词：超声心动图 先天性心脏病 心手综合征 遗传性心血管上肢畸形综合征 先天性上肢畸形 多指 并指 拇指发育不良 

分 类 号：R445.1[医药卫生—影像医学与核医学] R726.5[医药卫生—诊断学]