儿童二尖瓣置换超声心动图评估:一项单中心研究  

Echocardiographic evaluation of pediatric mitral valve replacement:a single-center study

作　　者：张琳悦 谢雨霁 任昭俐 李贺[1] 吴文谦 张丽[1] 李玉曼[1] 谢明星[1] Zhang Linyue;Xie Yuji;Ren Zhaoli;Li He;Wu Wenqian;Zhang Li;Li Yuman;Xie Mingxing(Department of Ultrasound Medicine,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Clinical Research Center for Medical Imaging in Hubei Province&Hubei Province Key Laboratory of Molecular Imaging,Wuhan 430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院超声医学科、湖北省影像医学临床医学研究中心、分子影像湖北省重点实验室,武汉430022

出　　处：《中华超声影像学杂志》2025年第1期17-25,共9页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金(82230066,82371991)。

摘　　要：目的探讨超声心动图在儿童二尖瓣置换术管理中的应用价值。方法回顾性分析2009年1月至2023年6月于华中科技大学同济医学院附属协和医院接受二尖瓣置换术治疗的患儿33例。收集患儿相关临床资料及术前、术后超声心动图资料。比较术前及术后1周、1个月、1年超声评价参数的变化。结果33例患儿中,二尖瓣狭窄4例(12.12%),二尖瓣反流33例(100%),二尖瓣狭窄合并反流4例(12.12%);机械瓣置换30例(90.91%),生物瓣置换3例(9.09%)。与术前比较,术后1周、1个月、1年左心房内径、左心室舒张末期内径明显减小(均P<0.05);术后1个月与术前相比,左心室质量明显降低,左心室舒张末期球形指数明显增加(均P<0.05);术后1年左心室射血分数较术后1周明显升高(P<0.05)。结论儿童二尖瓣置换术后左心内径缩小,心功能逐渐恢复。超声心动图是儿童二尖瓣置换术前准确评价及术后随访的重要手段。ObjectiveTo explore the application value of echocardiography in the management of pediatric mitral valve replacement.MethodsThirty-three children who underwent mitral valve replacement at Union Hospital Tongji Medical College Huazhong University of Science and Technology from January 2009 to June 2023 were retrospectively analyzed.Clinical data and preoperative and postoperative echocardiographic data were collected.The differences in ultrasound parameters among preoperative,1-week postoperative,1-month postoperative and 1-year postoperative were compared.ResultsOf the 33 children,there were 4 cases(12.12%)of mitral stenosis,33 cases(100%)of mitral regurgitation and 4 cases(12.12%)of mitral stenosis combined with regurgitation.Mechanical valve replacement was performed in 30 cases(90.91%)and bioprosthetic valve replacement in 3 cases(9.09%).Compared with the preoperative period,the left atrial internal diameter and left ventricular end-diastolic internal diameter were significantly reduced at 1-week postoperatively,1-month postoperatively,and 1-year postoperatively,respectively(all P<0.05).The left ventricular mass was significantly reduced and the left ventricular end-diastolic sphericity index was significantly increased(both P<0.05)at 1-month postoperatively compared with preoperatively.The left ventricular ejection fraction was significantly higher at 1-year postoperatively compared with 1-week postoperatively(P<0.05).ConclusionsAfter pediatric mitral valve replacement,the left ventricular dimensions decrease,and cardiac function progressively recovers.Echocardiography is an essential tool for accurate preoperative assessment and postoperative follow-up in pediatric mitral valve replacement.

关 键 词：超声心动描记术 二尖瓣置换术 儿童 

分 类 号：R726.5[医药卫生—儿科] R540.45[医药卫生—临床医学]