彩色多普勒超声心动图评估主动脉窦瘤破裂术前诊断和术后疗效的价值研究

Value of color Doppler echocardiography in assessing the preoperative diagnosis and postoperatively curative effect of ruptured aortic sinus aneurysm

目的:探讨彩色多普勒超声心动图(CDE)对主动脉窦瘤破裂(RASA)术前诊断和术后疗效评估的价值。方法:回顾性分析医院收治的78例RASA患者的临床资料,所有患者均接受手术治疗,术前及术后均应用CDE,以手术结果为金标准,观察CDE对RASA诊断价值及术后疗效评估价值。结果:术前CDE与手术结果比较,除1例右冠状动脉窦瘤破入至室间隔合并心内膜炎外,CDE均明确诊断出,诊断符合率为98.72%。术后7 d,所有患者的主动脉根部内径、左心室舒张期内径、左心室收缩期内径、右心室舒张期内径、右室流出道内径、左心房内径、右心房内径、主动脉瓣反流量、二尖瓣反流量、三尖瓣反流量等均较术前明显减小,差异具有统计学意义(t=-57.037,t=86.653,t=107.230,t=17.116,t=19.626,t=31.814,t=6.812,t=28.107,t=25.012,t=23.881;P<0.05);而左心室缩短率、左心室射血分数、肺动脉瓣反流量与术前相比,差异无统计学意义(t=0.494,t=1.440,t=-1.955;P>0.05)。结论:CDE在RASA术前诊断、选择手术方式及术后疗效评估中均具有重要运用价值。

Objective:To explore the value of color Doppler echocardiography(CDE)in assessing the preoperative diagnosis and postoperatively curative effect of ruptured aortic sinus aneurysm(RASA).Methods:The clinical data of 78 RASA patients admitted to hospital were retrospectively analyzed.All patients received surgical treatment,and CDE was used on them before and after operation.The operation result was used as gold standard to observe the diagnostic value of CDE for RASA and the evaluation value of that on postoperatively curative effect.Results:The comparison result of preoperative CDE and surgical results indicated that CDE could clearly diagnose RASA except for 1 case that right coronary sinus aneurysm ruptured into the ventricular septum with endocarditis,and the coincidence rate of diagnosis was 98.72%.The inner diameter of the aortic root,the inner diameter of the left ventricular diastole,the inner diameter of the left ventricular systole,the inner diameter of the right ventricle systole,the inner diameter of the right ventricular outflow tract,the inner diameter of the left atrium,the inner diameter of the right atrium,the aortic valve regurgitation flow,mitral valve regurgitation flow and tricuspid valve regurgitation flow of all patients at the 7th day after surgery were significantly lower than those before surgery,and the differences of them between before and after surgery were significant(t=-57.037,t=86.653,t=107.230,t=17.116,t=19.626,t=31.814,t=6.812,t=28.107,t=25.012,t=23.881,P<0.05).However,the differences of the left ventricular shortening rate,left ventricular ejection fraction and pulmonary valve regurgitation flow between before and after surgery were not statistically significant(t=0.494,t=1.440,t=-1.955,P>0.05).Conclusion:CDE has important applying value in the preoperative diagnosis of RASA,the choice of surgical approach,and the assessment of postoperatively curative effect.