彩色多普勒超声检测小儿重症肺炎时心脏右房室返流的临床应用

The clinical value of Doppler examination of infant suffered severe pneumonia with transient tricuspid regurgitation

目的描述小儿重症肺炎时心脏右房室返流的现象与特点,并探讨其临床价值.方法使用彩色多普勒超声对56例小儿重症肺炎进行心脏检测.结果小儿重症肺炎时心脏大小瓣膜形态及位置正常,56例中出现右房室返流47例,发生率83.8%.右房室返流程度多为轻度至中度,返流表现为：（1）从瓣口向右心房的反向血流信号,为＂五彩＂镶嵌血流,返流方向可垂直亦可斜向房间隔或右房侧壁.其最大返流速度为1.46～2.51 M/S;（2）右房室返流具有可逆性,随着小儿重症肺炎的治愈右房室返流基本可消失,仅5例由中度返流转为轻度返流.结论彩色多普勒对小儿重症肺炎时右房室返流的测出率明显高于右房室瓣听诊的杂音发现率,并可与先天性心脏病鉴别.对临床判断病情的程度、观察病情的变化以及疗效具有一定意义.

Objective To evaluate phenomenons and features of transient tricuspid regurgitation. Methods 56 cases of infant suffered severe pneumonia was examined by Doppler. Results The cardiac valves of the infant suffered severe pneumonia had normal shapes and location. 48 cases with transient tricuspid regurgitation was found. The rate of occurance was 83.8 96. Of these cases, most of them were in light level transient tricuspid regurgitation, a few were in medium level. The features were described as below： （1）The signal of reversed bloodstream from valve to right auricular was multicoloured. The direction of regurgitation was point to auricular septal or right auricular wall. The maximum velocity of regurgitation was 1.46-2.51M/S. （2）The transient tricuspid regurgitation had the features of reversibility. The transient tricuspid regurgitation could disappear nearly along with the recovery of severe pneumonia. Only 5 cases was transformed from medium level into light level. Conclusion The Doppler examination used in infant suffered severe pneumonia with transient tricuspid regurgitation is evidently superior to tricuspid valve auscultation, and the Doppler examination can be used to differentiate with congenital cardiac diseases. It is a useful method to evaluate the state,the variation and the curative effect of the illness.