超声心动图诊断急性肺栓塞的临床意义

Clinical value of echocardiography in diagnosis of acute pulmonary embolism

目的探讨经胸彩色多普勒超声心动图诊断急性肺栓塞的价值。方法对63例临床诊断为急性肺栓塞的患者行经胸超声心动图检查,与CT各参数比较;并将肺动脉高压患者分为3组,进行组间分析。结果超声心动图发现右房内血栓1例,主肺动脉干或左右肺动脉血栓3例,右心腔增大38例,肺动脉增宽33例,右室壁运动异常19例,肺动脉高压45例,肺动脉血流流速曲线异常19例。CT发现右房内血栓及肺动脉内血栓7例,右心系统形态改变及肺动脉高压例数均低于超声心动图。3组肺动脉高压患者随肺动脉收缩压(SPAP)升高,右室舒张末期内径(RVDD)与主肺动脉内径明显增大(P<0.05)。结论超声心动图简便易行,对急性肺动脉栓塞的诊断有非常重要的价值。

Objective To study the value of transthoracic echocardiography in the diagnosis of acute pulmonary embolism.Methods A total of 63 patients with acute pulmonary embolism in our hospital were examined by transthoracic echocardiography.The results were compared with CT results.The patients with pulmonary hypertension were divided into three groups and compared.Results Echocardiography showed 1 case with right atrial thrombosis,3 cases with main or left or right pulmonary artery thrombosis,38 cases with right heart enlargement,33 cases with widened pulmonary artery,19 cases with right ventricular wall motion abnormalities,45 cases with pulmonary hypertension,19 cases with abnormal pulmonary blood spectrum.CT found 7 cases with right atrial or pulmonary artery thrombosis.The number of patients diagnosed with altered right heart shape and pulmonary hypertension by CT was less than by echocardiography.The data from 3 pulmonary hypertension groups showed that with the systolic pulmonary artery pressure(SPAP) increasing the right ventricular end diastolic diameter(RVDD) and inner diameter of main pulmonary artery increased significantly(P<0.05).Conclusion Echocardiography is easy and convenient.It has very important value in the diagnosis of acute pulmonary embolism.