超声心动图在房间隔缺损经导管介入封堵术中的应用

The clinical value of echocardiography on atrial septal defect closure

目的评价超声心动图在房间隔缺损介入封堵术中的临床应用价值。方法于术前、术中,术后2d和2个月对61例房间隔缺损患者进行超声心动图检查,测量房间隔缺损的大小和位置,封堵器的位置和形态,右房和右室大小,右心功能和肺动脉内径。结果房间隔缺损封堵术后2d和2个月,房间隔封堵器的位置和形态正常。术后2d,右心房上下径和左右径、右室前后径、右室的舒张末期容积、每搏输出量、射血分数均较术前明显改善,P<0.05。术后2个月右室的前后径、舒张末期容积、收缩末期容积、每搏输出量、射血分数较术前进一步改善,差异均有显著统计学意义(P<0.01)。结论超声心动图在封堵术前后及随访过程中不仅能评价封堵器的位置、形态和功能,还能有效地跟踪检测术后右心功能和肺动脉内径的情况,为房间隔缺损介入封堵术的效果和预后提供有效的评价手段。

Objective To evaluate the clinical value of echocardiogaphy on occlusion operation in treating atrial septal defect （ASD）. Methods Sixty - one patients with ASD who were treated by transcatheter ASD closure were underwent echocardiography before operation, during operation, and two days and two months after operation. The size and position of ASD, the position and shape of ASD occluder, the diameter of right atrium and right ventricle and the function of right ventricle and the diameter of pulmonary artery were detected. Results Two days after operation, the position and shape of occluders were normal. The diameter of right atrium and right ventricle, right ventrieular end- diastolic volume（ RVEDV）, right ventrieular stroke volume（RVSV） and right ventrieular ejection fraction（RVEF） were better than that before occlusion operation（ P 〈 0.05）. Two months after operation, the diameter of right ventricle, RVEDV, RVESV, RVSV were further improved（ P 〈 0.01 ）. Conclusion Eehocardiography, as a safe and simple methods, plays not only an irreplaceable role in evaluating the position, shape and function of ASD oecluders, but also an effective methods in detecting the diameter of right atrium and pulmonary artery, the function of right ventricular.