原位心脏移植肺动脉压及右心功能的彩色多普勒超声评价

Color Doppler echocardiography evaluated pulmonary artery pressure and right ventricular function before and after orthotopic cardiac transplantation

目的探讨终末期扩张型心肌病病人心脏移植术前和术后早期肺动脉压和右心功能的临床意义。方法近2年6例心脏移植病人,术前和术后3～7d用彩色多普勒超声测量右心室前后径、右心室射血分数、肺动脉收缩压与舒张压、心包积液和三尖瓣反流程度。回顾分析术前肺动脉压和右心功能对术后早期右心功能和肺动脉压的影响。结果术前肺动脉高压病人右心室前后径增加(r=0.8227,n=6),右心室射血分数减少(r=-0.7361,n=6)。肺动脉压升高是引起右心扩大和衰竭的重要因素;术前肺动脉高压患者术后有明显下降,但仍处于高值;术前肺动脉压与术后右心室和肺动脉径和右心室射血分数改变不显著;术后三尖瓣反流和心包积液与术前和术后肺动脉压有关。结论手术前后应用彩色多普勒超声评估肺动脉压对心脏移植术前受体选择和早期术后恢复具有重要的临床意义。彩色多普勒超声测量肺动脉压和右心功能简便易行,重复性较好。

Objiectives To research the clinical value of pulmonary artery pressure and right ventricular function evaluated with color Doppler echocardiography before and after orthotopic cardiac transplantation. Methods The finding by color Doppler echocardiography in before operation was compared with finding after operation within 3-7 days. Results The right ventricular function and pulmonary artery pressure after operation were closed to the before. The pulmonary artery pressure and tricuspid valve regurgitation and pericardial effusions of these patients after operation were also related to the before. Conclusions The pulmonary artery pressure and right ventricular function evaluated with color Doppler echocardiography before and after orthotopic cardiac transplantation operation has impotent clinical values. Color Doppler echocardiography is an effective and practical method to evaluate the pulmonary artery pressure before and after orthotopic cardiac transplantation operation.