经食管超声心动图对老年卵圆孔未闭患者的研究分析

Research and analysis of transesophageal echocardiography for senile patent foramen ovale patients

目的探讨行经食管超声心动图对老年卵圆孔未闭(PFO)的临床诊断价值。方法回顾性分析59例老年PFO患者的临床特点,并通过彩色多普勒超声诊断仪检测老年PFO患者的超声心动图特点及心脏变化情况。结果老年PFO患者会出现不同程度的心功能不全症状,PFO患者伴有心房颤动、左右心室或心房扩大、肺动脉压升高等情况。本次14例治疗后病情好转,PFO消失或显示不清。经食管超声心动图血流频谱显示,48例患者的血液分流方向呈现左向右分流状态,7例重症患者呈现双向分流状态,4例重症患者为右向左分流。结论老年PFO患者有其独特的特征,多伴有心功能不全、心房颤动、左右心房及左右心室的扩大、肺动脉高压等,PFO血液分流方向多为左向右分流,出现双向分流或右向左分流的患者,预后较差。

Objective To investigate clinical diagnostic value by transesophageal echocardiography for senile patent foramen ovale（PFO）. Methods A retrospective analysis was made on clinical characteristics of 59 senile PFO patients, and color Doppler ultrasound diagnostic system was applied to detect echocardiography features and cardiac changes in patients. Results Cardiac insufficiency occurred by different degree in senile PFO patients, along with atrial fibrillation, left and right ventricle or atrial expansion, and increased pulmonary artery pressure. There were 14 improved cases with disappeared or unclear PFO. Transesophageal echocardiography blood flow frequency spectrum showed left-to-right shunt in 48 cases, bidirectional shunt in 7 severe cases and right-to-left shunt in 4 severe cases. Conclusion Senile PFO patients contain unique features, along with cardiac insufficiency, atrial fibrillation, left and right ventricle or atrial expansion, and pulmonary hypertension. Main shunt in PFO is left-to-right shunt, while bidirectional or right-to-left shunt in patients shows poor prognosis.