肺血管容积指数评估法乐四联症肺血管发育的临床应用价值

Pulmonary vascular volume index as a predictor of pulmonary vessel development in patients with tetralogy of Fallot

目的 探索能更好的评估肺血管发育情况的新指标,为确定法乐四联症的手术指征提供依据.方法 采用25例法乐四联症患儿的CTA三维重建图像,测算McGoon指数、Nakata指数,并利用64排螺旋CT自身配置的容积测算软件计算肺血管容积指数,再与术后情况进行相关分析.结果 Nakata指数与术后恢复情况的相关性比McGoon指数高.肺血管容积指数与术后监护时间、呼吸机维持时间、正性肌力药物用量的相关性比Nakaha指数更高.肺血管容积指数≤120cm^3/m^3时,血液动力学很不稳定,对正性肌力药物依赖性大,病死率明显增加.结论 肺血管容积指数可以有效的评估肺血管发育情况,对法乐四联症手术方案的选择及根治术的预后评估具有指导意义.

Objective To explore the efficacy of pulmonary vascular index（PVVI）in predicting pulmonary vessel development in patients with tetralogy of Fallot（TOF）.Methods Twenty five TOF patients＇ McGoon index and Nakata index were ealculated on the CTA three dimensional reconstructed films,and their pulmonary vascular volume index was calculated using 64-slice spiral CT assisted volume measurement system.The correlative analysis was performed to analyze the relationship between different indexes and clinical outcome.Results Nakata index was more correlated with the postoperative recovery compared with McGoon index.The length of stay in ICU,mechanical ventilation time,doses of positive inotropic drugs were found to be correlated with PVVI better than Nakata index.In children with total PVVI less than 120 cm^3/m^2,postoperative hemodynamic parameters were unstable and associated with low cardiac output syndrome and high mortality.Conclusions PVVI is promising in evaluating the pulmonary vessels development and predicting the clinical outcome.