本文選題：超聲心動圖　切入點：心血管畸形　出處：《北京大學學報(醫(yī)學版)》2017年05期 　論文類型：期刊論文

【摘要】：目的:評價超聲心動圖對嬰幼兒心下型完全性肺靜脈異位連接的診斷價值。方法:回顧性分析2006年4月至2016年12月經(jīng)超聲心動圖診斷的8例心下型完全性肺靜脈異位連接患兒,其中男4例、女4例,年齡15~195d,平均年齡79.8 d。超聲從胸骨旁、劍突下、心尖多個切面,觀察肺靜脈異位引流的途徑及位置,右心房、右心室的擴大程度,心房水平分流方向等。結(jié)果:8例心下型完全性肺靜脈異位連接患兒中,6例行CT檢查,5例行手術(shù)治療。超聲心動圖檢出7例,漏診1例,診斷準確率為87.5%。本病的間接超聲征象為小的畸形左心房和心房水平右向左分流,肝、門靜脈擴張迂曲,肝內(nèi)血流豐富;直接征象為左、右肺靜脈未回流左心房,匯成共同肺靜脈干,匯入垂直靜脈后經(jīng)右下行穿越膈肌至門靜脈或肝靜脈。劍突下切面可顯示3條平行走行的血管,即垂直靜脈、腹主動脈和下腔靜脈,前二者與后者血流方向相反。8例患兒垂直靜脈膈下回流部位均為門靜脈,3例患兒存在降垂直靜脈與門靜脈或肝靜脈連接處梗阻。結(jié)論:超聲心動圖對診斷小兒心下型完全性肺靜脈異位連接具有重要價值,能為外科術(shù)前評估提供結(jié)構(gòu)及血流動力學信息。采用多聲窗、多切面及連續(xù)追蹤法觀察心下型完全性肺靜脈異位連接異位引流的肺靜脈行程,可對其作出準確診斷,但須與混合型肺靜脈異位引流及肝內(nèi)門-體靜脈分流或肝動脈-靜脈瘺等疾病相鑒別。
[Abstract]:Objective: to evaluate the value of echocardiography in the diagnosis of infantile subcardiac complete pulmonary venous ectopic connection. Methods: eight cases of infantile subcardiac complete pulmonary venous ectopic connection diagnosed by echocardiography from April 2006 to 2016 were analyzed retrospectively. There were 4 males and 4 females with an average age of 79.8 d. Ultrasound was used to observe the way and location of anomalous pulmonary venous drainage, the degree of enlargement of right atrium and right ventricle from the sternal side, under the xiphoid process and at the apex of the heart. Results in 8 cases of subcardiac complete pulmonary venous ectopic connection, 6 cases underwent CT examination and 5 cases were treated surgically, 7 cases were detected by echocardiography, 1 case was missed diagnosis. The diagnostic accuracy was 87.5%. The signs of indirect ultrasound were left atrium and left atrial shunt, liver and portal vein dilated and tortuous, blood flow was abundant in liver, direct sign was left, right pulmonary vein did not return to left atrium, right pulmonary vein did not return to left atrium, right pulmonary vein did not return to left atrium, right pulmonary vein did not return to left atrium. Converging into the common pulmonary vein trunk, flowing into the vertical vein through the lower right diaphragm to the portal vein or hepatic vein. The inferior facet of the sword process shows three parallel vessels, namely, the vertical vein, the abdominal aorta, and the inferior vena cava. The former two were opposite to the latter in the direction of blood flow. The subphrenic circumfluence of the vertical veins in all cases was portal vein obstruction in 3 cases. Conclusion: echocardiography is useful in diagnosis of children's heart with the presence of obstruction at the junction of vertical vein and portal vein or hepatic vein. The subtotal pulmonary venous ectopic connection is of great value. It can provide the information of structure and hemodynamics for preoperative evaluation of surgery. Using multi-sound window, multi-section plane and continuous tracing method, we can observe the itinerary of pulmonary vein with complete anomalous connection of pulmonary vein and ectopic drainage of subcardiac type, and make an accurate diagnosis of it. But it should be distinguished from mixed pulmonary venous ectopic drainage and portal venous shunt or hepatic arterial-venous fistula.
【作者單位】： 泰達國際心血管病醫(yī)院超聲科;
【分類號】：R540.45;R725.4

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本文編號：1630963