经胸彩色多普勒超声在先天性心脏病封堵治疗中的应用

Applied Value of Transthoracic Echocardraphy for Occlusion of Congenital Heart Diseases

目的探讨经胸彩色多普勒超声诊断先天性心脏病临床价值。方法16例先天性心脏病患者,术前应用经胸彩色多普勒超声观察房间隔、室间隔缺损及动脉导管的大小、位置、形态、类型,选择封堵伞的大小、型号,术中监测封堵器的释放情况,观察有无分流、瓣膜返流、右室流出道血流速度的变化。结果16例患者,房间隔缺损大小平均为1.8cm,室间隔缺损大小为0.75cm,动脉导管未闭0.63cm。室间隔缺损口距瓣膜距离过小者应用偏心型封堵器。1例室缺患者封堵后右室流出道血流速度过快,1例房缺患者因术中二尖瓣出现大量返流而撤伞。16例患者成功率为87.5%。结论经胸彩色多普勒超声能准确的观察各种先天性心脏病的大小、形态及周边的结构关系。对于病例的选择、术中引导和监护、术后随访等方面均具有重要意义。

Objective To evaluate the applied value of transthoratic echocardiography during perioccolusion of defective congential heart diseases. Methods Sixteen patients with defective congenital heart diseases were subjected to occlusion. The group including 6 case of ASD（atrial septal defect）,8 of VSD（ventricular septal defect） , and 2 of PDA（patent ductus arteriosus）. The type,size and shape of defections were detected before operation echocardiographically; occlusion of defection were monitored during operation and therapeutic effect were observed after operation. Results The ASD diameter by echocardiography was 0.7-2.1 cm with an average of 1.8 cm. The VSD diameter was 0.35 - 1.1 cm with an average of 0.75 cm. The PDA diameter was 0.37-0.9 cm with an average of 0.63 cm. Asymmetric duct occluder should be used in VSD in which the valve was close to the port. The success rate in 16 patients was 87.5%. Conclusion Echocardiography plays a very important role in selecting candidates before operation,guiding and monitoring during operation, following up after operation.