单中心儿童永存左上腔静脉合并先天性心脏病的超声心动图分析

Persistent left superior vena cava accompanying congenital heart disease detected using echocardiography in children:experience of a single center

目的应用超声心动图分析永存左上腔静脉(PLSVC)患儿合并先天性心脏病种类,提高超声诊断PLSVC及相关心脏畸形的准确率。方法回顾性分析我院2013~2017年行超声心动图检查的212309例患儿的超声心动图资料及临床资料,其中先天性心脏病患儿28403例,永存左上腔静脉患儿1676例,分析永存左上腔静脉合并先天性心脏病类型的分布特征及发生率。结果永存左上腔静脉的检出率约0.79%(1676/212 309),其中Ⅰ型永存左上腔静脉最常见约占99.7%(1671/1676)。永存左上腔静脉在先天性心脏病患儿中的检出率约3.0%(866/28403)。1676例永存左上腔静脉的患儿中,合并先天性心脏心脏病的患儿866例(51.7%),常见的为室间隔缺损202例(23.3%)、房间隔缺损149例(17.2%)、法洛四联症73例(8.4%)、动脉导管未闭58例(6.7%)、主动脉该缩窄及主动脉缩窄复合畸形52例(6.0%)、心内膜垫缺损34例(4.0%)、右室双出口29例(3.3%)。结论永存左上腔静脉常合并先天性心脏大血管畸形;超声心动图检查可准确诊断永存左上腔静脉及其合并畸形,能够为临床制定患儿治疗方案提供可靠依据。

Objective To improve the understanding of the types and incidence of concomitant congenital heart disease in children with persistent left superior vena cava.Methods The echocardiographic and clinical data of 212 309 children who underwent echocardiography in our hospital from 2013 to 2017 were analyzed retrospectively.There were 28 403 children with congenital heart disease and 1676 children with persistent left superior vena cava.The distribution characteristics and incidence of congenital heart disease were analyzed.Results The incidence of persistent left superior vena cava was 0.79%(1676/212 309)in all children,and typeⅠpermanent left superior vena cava was the most common accounting for 99.7%(1671/1676).The incidence of persistent left superior vena cava was 3.0%(866/28 403)in children with congenital heart disease.A total of 1676 children with persistent left superior vena cava,866(51.7%)of whom were diagnosed with congenital heart disease.Of all the 1676 children,the common concomitant congenital heart disease were ventricular septal defect(202 cases,23.3%),atrial septal defect(149 cases,17.2%),tetralogy of Fallot(73 cases,8.4%),patent ductus arteriosus(58 cases,6.7%),isolated aortic coarctation and the aortic coarctation complex(52 cases,6.0%),endocardial pad defect(34 cases,4.0%),double outlet right ventricle(29 cases,3.3%).Conclusion Increased awareness about the associaton of certain congenital heart disease with persistent left superior vena cava and a careful echocardiographic examinaton can facilitate the diagnosis of left superior vena cava.In additon,precise prior diagnosis of persistent left superior vena cava and its associated deformities can provide a reliable basis of the treatment.