12岁以上青少年及成年人Ebstein畸形手术前后的超声心动图评估  

Echocardiographic Evaluation of Short-term Outcomes of Surgical Treatment for Ebstein's Anomaly Above 12 Years of Age in Adolescents and Adults

作　　者：江勇[1] 王浩[1] 逄坤静[1] 樊丽姿[1] 王建德[1] 孙欣[1] 吴伟春[1] 焦盼晴[1] 

机构地区：[1]中国医学科学院 北京协和医学院 国家心血管病中心 阜外心血管病医院超声科 心血管疾病国家重点实验室,北京市100037

出　　处：《中国超声医学杂志》2015年第6期501-504,共4页Chinese Journal of Ultrasound in Medicine

基　　金：首都医学发展基金(No.2007-shF05)

摘　　要：目的应用超声心动图评价12岁以上青少年及成年人Ebstein畸形外科手术疗效。方法 58例12岁以上青少年及成年人Ebstein畸形患者在术前及术后2周内分别进行超声心动图检查,分别测量左、右心室前后径、三尖瓣环大小、三尖瓣前向流速、三尖瓣反流分级。结果 58例Ebstein畸形患者中,术前隔叶下移57例,后叶下移58例,隔叶缺如1例,前叶下移1例,其余三尖瓣前叶均无下移,但发育冗长,房化右室形成,所有病例均有右房扩大、三尖瓣瓣环扩张及三尖瓣反流,以3~5级为主。2例Glenn手术,2例人工瓣置换。54例成功进行三尖瓣成形,术后超声心动图显示三尖瓣环缩小,瓣膜反流明显减少,以2级及以下为主,右室大小及三尖瓣瓣环大小明显回缩。结论超声心动图可以便捷地评价12岁以上青少年及成年人Ebstein畸形术前及术后三尖瓣结构与功能、右心室大小变化,确定手术疗效。Objective To study the value of echocardiographic evaluation in pre and post operation of Ebstein’s anomaly above 12 years of age in adolescents and adults.Methods We described our experience in using echocardiography in the assessment of 58 patients with Ebstein’s anomaly above 12 years of age in adolescents and adults retrospectively.The level of displacement of the tricuspid apparatus,the size of right ventricle and left ventricle,the size of the tricuspid annular diameter,severity of tricuspid regurgitation were evaluated.All patients were followed up by echocardiography,and the data of preoperation were compared with that of postoperation.Results Preoperatively,these changes included a downward displacement of the hinge point of the posterior and septal leaflets,enlarged right atria and right ventricles and a severe preoperative tricuspid regurgitation(TR,grade 3to 5).Postoperatively TR was significantly reduced(TR,grade 0to 2),and the enlargement in tricuspid valve ring returned to normal.ConclusionsEchocardiography is useful in accurate diagnosis of the Ebstein’s anomaly preoperationly,showing the morphology of the valve leaflets,and the tricuspid regurgitation.Echocardiography were able to identify surgical effect in Ebstein’s anomaly above 12 years of age in adolescents and adults after operation.

关 键 词：超声心动图 EBSTEIN畸形 瓣膜功能 疗效 

分 类 号：R654.2[医药卫生—外科学] R540.45[医药卫生—临床医学]