原位心脏移植术后多普勒超声心动图的重要性评价  

The evaluation of the importance of Doppler echocardiogram to orthotopic heart transplantation

作　　者：王鸿[1] 陈龙[2] 李慧忠[1] 耿丹明[1] 洪俊峰[1] 

机构地区：[1]南京军区福州总医院,超声科,350025 [2]南京军区福州总医院,心胸外科,350025

出　　处：《福建医药杂志》2003年第3期1-3,共3页Fujian Medical Journal

摘　　要：目的　评价多普勒超声心动图在原位心脏移植术后的作用 ,以避免心内膜下心肌活检带来的损害。方法　 2例心脏移植术后患者应用多普勒超声心动图仪进行床边的密切跟踪 ,随时记录心脏移植术后的解剖结构、心脏血流动力学特别是二尖瓣 E、A峰的变化等综合判断可能出现的排斥反应情况。结果　术后明显特征改变是供、受体心房缝合缘的清楚显示 ,及右心房上下径增大 ;右室短期内肥厚扩大 ,1例出现室间隔和左室后壁一过性增厚 ;心包积液的出现 ,以扩张性心肌病心脏移植术后增加明显 ;房室瓣返流及 1例出现主动脉瓣返流。本组 2例心脏收缩功能正常及舒张功能一过性轻度降低 ,二尖瓣 E、 A峰轻度变化。结论　心脏移植术后处理是确保心脏移植成功的关键。多普勒超声心动图可在术后 2 4小时开始检测跟踪 ,随时准确地提供以上各项指标变化 。Objective Evaluate the Doppler echocardiographic effection to orthotopic heart transplanted and avoid the damage of endomyocardial biopsies.Methods Two patients who received homologous orthotopic heart transplantation were followed up with echocardiography according to clinical necessity.Results Donor recipient atrial anastomosis protruded into both right and left atrial cavities,the up down dimension of right atrial was lengthened,and the right ventricular wall was temporarily thickening.One patient showed temporarily thickening of the left ventricular wall.Small quantity of pericardial effusion especially presented in dilated cardiomyopathy.Two patients were normal of the left ventricular systolic function,temporarily decrease of the diastolic function and the velocity of E peak and A peak were change lightly.Conclusion Effective postoperative treatment is crucial for successful heart transplantation.Doppler Echocardiography is useful in the follow up of heart transplant recipients.

关 键 词：原位心脏移植术 术后 多普勒超声心动图 排斥反应 

分 类 号：R445.1[医药卫生—影像医学与核医学]