超声心动图对急性肺栓塞诊断的临床应用价值

The clinical value of echocardiography in the diagnosis of acute pulmonary embolism

目的观察超声心动图在急性肺栓塞诊断中的临床应用价值。方法应用超声心动图观察34例急性肺栓塞患者（研究组）右房室内径、主肺动脉内径、左肺动脉内径、右肺动脉内径、右室舒张末期容积、右室射血分数、三尖瓣返流量和速度、肺动脉收缩压等指标，并以34例同年龄的心血管疾病及其危险因素相似的志愿者作为对照组。结果研究组患者中直接检出右房、右室附壁血栓各1例，主肺动脉及左、右肺动脉主干血栓7例。研究组患者右房长径、右房横径、右室横径、主肺动脉内径、右肺动脉内径、左肺动脉内径及右室舒张末期容积均大于对照组（P〈0．01）；其肺动脉收缩压高于对照组，而右室射血分数低于对照组（P〈0．01）。结论超声心动图可无创评估急性肺栓塞患者的右心负荷，能检出肺动脉内大块血栓。

Objeetive To evaluate the clinical value of echocarliography in the diagnosis of acute pulmonary embolism. Methods Compared with volunteers of 34, the right atrial and ventricular diameters, pulmonary artery inner diameters, right ventrieular end diastolic volume, right ventrieular ejection fraction, tricuspid valvular regurgitation and pulmonary artery systolic pressure had been observed by using transthoracie echocardiography or bedside eehocardiography. Results Seven of 34 cases were detected the unattached thrombi in main pulmonary artery and/or the hranch of pulmonary artery, and the thrombi were observed in right atrium of I case and in right ventricle of I case. Right atrial and ventrieular diameters ,right ventricular end diastolic volume and pulmonary artery inner diameters in study group were much larger than those in the control group（P 〈 0.01 ）. The pulmonary artery systolic pressure was higher and right ventrieular ejection fraction decreased in study group compared with that in the control group （P〈 0.01 ）. Conclusions Echocardiography could evaluate the right heart overload,and even detect thrombi in pulmonary artery of pulmonary embolism.