经颅多普勒对成人卵圆孔未闭的诊断及价值研究

Diagnosis and Value Study of Transcranial Doppler for Adult Patent Foramen Ovale

目的探究经颅多普勒对成人卵圆孔未闭的临床诊断。方法选取2022年6月—2023年6月在本院神经内科就诊的78例不明原因脑卒中或偏头痛患者为研究对象,按照检查方法分为试验1组(n=39)与试验2组(n=39),试验1组应用经颅多普勒超声检查,试验2组应用经胸心脏超声心动图检查。比较两组诊断的阳性率、上腔静脉血流频谱等情况。结果试验1组检查卵圆孔未闭的阳性率明显高于试验2组,组间差异有统计学意义(P<0.05)。在静息状态及瓦氏呼吸下,试验1组与试验2组的D波、S波峰值速度相比,差异无统计学意义(P>0.05);但静息状态时,D波较S波峰值速度明显降低,差异有统计学意义(P<0.05);瓦氏呼吸下,D波也明显低于S波峰值速度,差异有统计学意义(P<0.05)。试验1组分流角度明显低于试验2组,差异有统计学意义(P<0.05);隧道长度、原发隔活动度明显高于试验2组,差异有统计学意义(P<0.05)。结论经颅多普勒超声检测成人卵圆孔未闭具有更高的诊断价值,能清晰观察到脑部解剖结构及血流动力变化,可为临床诊治提供有力的依据。

Objective To explore clinical diagnosis of patent foramen ovale of adults with transcranial Doppler.Methods The paper chose 78 patients with unexplained stroke or migraine in neurology department of our hospital from June 2022 to June 2023 as study subjects,and divided them into experiment group 1(n=39)and experiment group 2(n=39)according to examination method.Experiment group 1 was treated with transcranial Doppler ultrasound examination,and experimental group 2 with transthoracic echocardiography examination.Positive rates of diagnosis and the frequency spectrum of superior vena cava blood flow were compared between two groups.Results Positive rate of patent foramen ovale in group 1 was 56.41%,significantly higher than 35.90%in group 2(P<0.05).Comparison of peak velocities of D and S waves between group 1 and 2 in a resting state and under Waals breathing showed P>0.05.But in a resting state,peak velocity of the D wave was significantly lower than S wave(P<0.05).Under Waals breathing,peak velocity of D wave was significantly lower than S wave(P<0.05).Diversion angle of group 1 was significantly lower than group 2(P<0.05).Length of the tunnel and the activity of primary septum was significantly higher than experimental group 2(P<0.05).Conclusion Transcranial Doppler ultrasound has higher diagnostic value in detecting patent foramen ovale of adults,can observe the anatomical structure and hemodynamic changes of brain clearly,and provide favorable basis for clinical diagnosis and treatment.