本文關(guān)鍵詞：兩種造影劑在經(jīng)顱多普勒超聲診斷卵圓孔未閉中的診斷陽性率對比　出處：《南方醫(yī)科大學(xué)學(xué)報》2016年08期 　論文類型：期刊論文

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【摘要】：目的比較生理鹽水-氣體混合液(AS)和生理鹽水-氣體-血混合液(ASb)這兩種造影劑在經(jīng)顱多普勒超聲(c-TCD)診斷卵圓孔未閉(PFO)方面的差異。方法收集2015年11月~2016年1月在我院TCD室行c-TCD檢查患者248例,通過擲硬幣法決定AS或ASb這兩種造影劑使用的先后順序。然后分別均在不伴Valsalva動作(VM)與伴VM情況下,注入造影劑(CA),通過觀察TCD頻譜,記錄CA注射后25 s內(nèi)微泡數(shù)目及第一個微泡出現(xiàn)的時間。具體操作方法如下:(1)9 m L生理鹽水混合1 m L空氣不伴VM(AS不伴VM);(2)9 m L生理鹽水混合1 m L空氣伴VM(AS伴VM);(3)9 m L生理鹽水、1滴患者回抽血液混合1 m L空氣不伴VM(ASb不伴VM);(4)9 m L生理鹽水、1滴患者回抽血液混合1 m L空氣伴VM(ASb伴VM)。上述每種方法重復(fù)2次,且每個過程間隔至少5 min。根據(jù)微泡數(shù)量對PFO分流程度進行分級:0級,陰性;Ⅰ級,1~10個微泡;Ⅱ級,10個微泡但未形成"雨簾";Ⅲ級,形成雨簾狀。結(jié)果 AS不伴VM、AS伴VM、ASb不伴VM和ASb伴VM檢查的陽性率分別是10.9%、23.8%、12.1%、25.8%。AS伴VM組發(fā)泡陽性率較AS不伴VM組顯著增高,具有統(tǒng)計學(xué)差異(23.8%vs 10.9%,P=0.001);ASb伴VM組發(fā)泡陽性率較ASb不伴VM組顯著增高,具有統(tǒng)計學(xué)差異(25.8%vs 12.1%,P=0.001);ASb不伴VM組發(fā)泡陽性率與AS不伴VM組相比差異無統(tǒng)計學(xué)意義(12.1%vs 10.9%,P=0.250);ASb伴VM組發(fā)泡陽性率與AS伴VM組相比差異無統(tǒng)計學(xué)意義(25.8%vs 23.8%,P=0.125)。結(jié)論應(yīng)用c-TCD檢測PFO時VM能夠提高診斷陽性率,而AS與ASb這兩種造影劑在診斷PFO陽性率方面無明顯差異。
[Abstract]:Objective to compare the diagnosis of PFOO with normal saline gas mixture (ASB) and saline gas blood mixture (ASB) in transcranial Doppler echocardiography (TCD) in the diagnosis of unobturated foramen ovale (PFOO). Methods from November 2015 to January 2016, 248 patients were examined with c-TCD in our TCD room. The order of use of as or ASb was determined by coin toss method. Then the contrast agent was injected without Valsalva and VM respectively. By observing the TCD spectrum. The number of microbubbles and the time of occurrence of the first microbubble were recorded 25 seconds after CA injection. ; (2) 9 mL normal saline mixed with 1 mL air with VM(AS with VMN; One drop of 9 mL normal saline was used to draw back blood and mixed 1 mL air without VM(ASb without VMN. The blood was mixed with VM(ASb and VMN in patients with 9 mL normal saline and 1 drop of blood. Each of the above methods was repeated twice. According to the number of microbubbles, the PFO shunt degree was graded into grade 0: 0 and negative. Grade I 1 ~ 10 microbubbles; Grade 鈪，

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