经胸超声心动图对肺动脉吊带患者诊断的临床价值

Clinical value of transthoracic echocardiography in the diagnosis in patients of pulmonary artery sling

目的:探讨经胸超声心动图对于肺动脉吊带的诊断、鉴别及指导治疗的临床价值。方法:对2007年1月至2023年6月间,我院儿童心脏中心收治并经手术证实的28例肺动脉吊带患者的超声心动图及临床资料进行回顾性分析。总结超声诊断特点及鉴别诊断,分析误诊、漏诊原因。结果:28例患者均行外科根治术,26例手术所见与超声心动图诊断结果完全相符,无1例漏诊合并畸形,仅2例患者超声提示左肺动脉内径轻度狭窄但术中探查左肺动脉内径尚正常。85%患者合并永存左上腔静脉、室间隔缺损、房间隔缺损等心内畸形。超声诊断要点为肺动脉分叉消失,主肺动脉直接延续为右肺动脉,于右肺动脉发出异常起源的左肺动脉。结论:超声心动图可早期无创准确诊断肺动脉吊带及心内合并畸形,并为进一步外科手术治疗与预后提供可靠依据,具有重要临床价值。

Objective:To investigate the clinical value of transthoracic echocardiography in the diagnosis,differentiation and treatment of pulmonary artery sling(PAS).Methods:From January 2007 to June 2023,28 patients with PAS admitted to the children's heart center of our hospital and confirmed by operation and their clinical echocardiography were analyzed retrospectively.The characteristics and differential diagnosis of echocardiography were summarized,and the reasons of misdiagnosis and missed diagnosis were analyzed.Results:All of the 28 cases were treated by PAS surgery operation.The findings of 26 cases were in accordance with the diagnosis of echocardiography,the diameter of the left pulmonary artery was found to be slightly narrowed in only 2 patients by echocardiography,but they were normal in surgery.85%patients had persistent left superior vena cava,ventricular septal defect and atrial septal defect.The main points of ultrasound diagnosis were that the bifurcation of pulmonary artery disappeared,the main pulmonary artery continued to be the right pulmonary artery directly,and the left pulmonary artery originated abnormally from the right pulmonary artery.Conclusions:Echocardiography can accurately diagnose PAS and cardiac malformation in early stage,and provide reliable basis for further surgical treatment and prognosis.So It has important clinical value in PAS.