心脏外科手术患者的超声心动图研究

ECHOCARDIOGRAPHIC STUDY ON PATIENTS RECEIVED HEART SURGERY

目的:探讨不同心脏疾病类型的心脏外科手术患者超声心动图表现。方法:对68例心脏外科手术患者根据疾病类型进行分组,采用心脏彩色多普勒超声心动图仪测量右心室流出道(RVOT)、左心室后壁厚度(LVPW)、右心室前后径(RV)及主肺动脉(MPA)、主动脉内径(AOD)、左心室舒张末期内径(LVDd)、左心室收缩末期内径(LVDs)、左房内径(LAD)等指标,并比较组间差异。结果:①12岁以下的患者,法洛氏四联征(TOF)组RVOT、MPA均小于房间隔缺损(ASD)组和室间隔缺损(VSD)组(P<0.01),TOF组主动脉内径(AOD)三组最大(P<0.01);ASD组RV明显大于VSD组和TOF组(P<0.01);VSD组左心室舒张末期内径(LVDd)、左心室收缩末期内径(LVDs)均大于ASD组和TOF组(P<0.01);②20岁以上的患者,与先天性心脏病+窦性心律组相比较,风湿性心脏病+窦性心律组和风湿性心脏病+心房颤动组LVDd、LVDs明显增大(P<0.05),风湿性心脏病+心房颤动组左房内径(LAD)明显大于先天性心脏病+窦性心律组(P<0.01)。结论:超声心动图对先天性心脏病、风湿性心脏病及心房颤动等心脏外科手术疾病的术前诊断、治疗具有重要的临床价值。

Objective：To observe the changes of doppler echocardiography in patients with different cardiac diseases. Methods： 68 patients underwent echocardiography and heart surgery were divided into different cardiac disease groups. RVOT （Right ventricular outflow tract）, AOD （aortic root dimension）, LAD （left atrial dimension）, LVDd （left ventricular internal dimension at end diastole） ,LVDs （left ventricular internal dimension at end systole）, IVS （interventricular septal thickness at end-diastole）, LVPW（left ventricular posterior wall）, RV （right ventricle）, MPA （main puhnonary artery ） and other cardiac data were measured. Results：①In patients under 12 years old,there was significant difference of RVOT,MPA,RV,AOd,LVDd and LVDs among the （ASD）group,（VSD） group and （TOF）group, in oatients above zo years old, but no significant difference of LAD,IVs,and LVPW.② In patients above 20 years old,LVDd and LVDs in the （RHD＋SR） or （RHD＋AF） group were larger than that in the （CHD＋SR） group （P〈O.05）, but there were no difference between the RHD＋SR group and RHD＋AF group （P〉 0.05）; LAD （left atrial dimension） was significantly higher in the RHD＋AF group than that in the CHD＋SR group （P〈0.01）.Conclusion： Echocardiography is especially helpful for the diagnosis and clinical therapy of congenital heart diseases , rheumatic heart disease and atrial fibrillation .