超声心动图在诊断主肺动脉间隔缺损中的应用价值  

How to avoid misdiagnosis of aorticopulmonary septal defect by echocardiography

作　　者：刘延玲[1] 李靖[1] 王浩[1] 吕秀章[1] 朱振辉[1] 凌雁[1] 许闻桥[1] 

机构地区：[1]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院超声科,北京100037

出　　处：《中华心血管病杂志》2003年第9期678-680,共3页Chinese Journal of Cardiology

摘　　要：目的　提高超声心动图对主肺动脉间隔缺损的诊断准确率。方法　 2 7例主肺动脉间隔缺损的患者 ,男性 14例 ,女性 13例 ,应用经胸超声心动图超声检查 ,通过观察左心室长轴、升主动脉长轴、双动脉长轴、大动脉短轴及胸骨上窝主动脉弓长轴断面 ,观察主肺动脉间隔缺损的大小、部位、容量负荷增加的状况及肺动脉高压的程度。与手术结果相对照 ,找出漏诊的原因。结果　 2 7例患者中 ,2 1例手术结果为主肺动脉间隔缺损 ,缺损的范围为 1 3～ 2 5cm ,其余 6例经心血管造影证实为本病。术前超声作出明确诊断者 14例 ,而其余 13例患者仅提示为左心容量负荷增加。除 6例患者为单纯的主肺动脉间隔缺损外 ,其余 2 1例患者均合并其他不同的心内畸形。结论　随着超声心动图科学技术的发展及操作技巧的日趋完善 。Objective To improve the accuracy of echocardiographic diagnosis in patients with aorticopulmonary septal defect Methods Twenty seven patients, 14 male and 13 female, with aorticopulmonary septal defect were examined with echocardiography using long axis view of left ventricle, ascending aorta, aortic arch and bi arteries, and short axis view of great arteries The location and size of aorticopulmonary septal defect were detected and also the situation of volume overload and pulmonary hypertension were evaluated The causes of misdiagnosis were found after comparing the results of echocardiography with surgical results Results Among 27 patients with aorticopulmonary septal defect, 6 patients were confirmed by angiography and 21 by open heart surgery with the defect 1 3～2 5 cm in diameter, and 21 cases with other various cardiovascular anomalies Echocardiography made an accurate diagnosis before operation in 14 cases, but observed only the volume overload of left ventricle in 13 cases Conclusion Echocardiography can make accurate diagnosis of aorticopulmonary septal defect following the development of ultrasonic techniques and improvement of skill of echocardiography

关 键 词：超声心动图检查 诊断 主肺动脉间隔缺损 先天性心脏病 漏诊 

分 类 号：R541.1[医药卫生—心血管疾病] R540.45[医药卫生—内科学]