本文選題：超聲心動圖 + 二尖瓣置換術(shù)��； 參考：《福建醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的 1.探討全方向M型超聲心動圖評價(jià)二尖瓣置換術(shù)中患者右心功能的應(yīng)用價(jià)值。 2.分析全方向M型超聲心動圖與其他超聲定量技術(shù)的相關(guān)性。 方法 1.研究對象:對照組30例，單純二尖瓣狹窄行二尖瓣置換術(shù)的患者58例。 2.儀器:LEJ-2型全方向M型超聲心動圖系統(tǒng)，GE Vivid-7Dimension彩色超聲心動圖診斷儀配有Echo PAC工作站。 3.方法:(1)應(yīng)用經(jīng)食道超聲心動圖采集所有患者術(shù)前、術(shù)后連續(xù)3個(gè)心動周期系列切面圖像。分別應(yīng)用定量組織速度成像技術(shù)（quantitative tissue velocityimaging，QTVI）及LEJ-2型全方向M型超聲心動圖（Omni-directional M-modeechocardiography，，OME）測量三尖瓣環(huán)收縮期峰值速度（Sa）；應(yīng)用二維超聲斑點(diǎn)追蹤成像技術(shù)（two dimension speckle-tracking imaging，2D-STI）測量所有研究對象右室心肌收縮期縱向峰值應(yīng)變（S）；分別應(yīng)用OME及解剖M型超聲心動圖（anatomic M-mode echocardiography，AMM）測量對照組左室短軸切面乳頭肌水平各壁收縮期峰值速度。(2)比較術(shù)后三尖瓣環(huán)收縮期峰值速度較術(shù)前變化情況，并分析Sa與肺動脈收縮壓（pulmonary arterial systolicpressure，PASP）的相互關(guān)系。分析OME與QTVI測值之間、OME與2D-STI測值之間及OME與AMM測值之間的相關(guān)性。 結(jié)果 1.術(shù)后三尖瓣環(huán)大部分位點(diǎn)收縮期峰值速度較術(shù)前增加（P0.01）。 2.三尖瓣環(huán)收縮期峰值速度與PASP成負(fù)相關(guān)（r=-0.85, P0.01）。 3. OME與QTVI技術(shù)測值比較差異無統(tǒng)計(jì)學(xué)意義（P0.05），相關(guān)分析顯示相關(guān)性良好（r=0.94，P0.01）。OME與2D-STI技術(shù)測值相關(guān)分析顯示相關(guān)性良好（r=0.95，P0.01）。OME與AMM技術(shù)測量左室乳頭肌水平各壁收縮期峰值速度差異無統(tǒng)計(jì)學(xué)意義（P0.05），相關(guān)分析顯示相關(guān)性良好（r=0.81，P0.01）。 結(jié)論 全方向M型超聲心動圖能夠準(zhǔn)確、實(shí)時(shí)、即刻評價(jià)右室心肌各個(gè)運(yùn)動方向的綜合作用力，較快地反映二尖瓣置換術(shù)患者的右心功能。為心臟外科醫(yī)生及麻醉師提供有用的依據(jù)。在術(shù)中監(jiān)測評價(jià)二尖瓣置換術(shù)患者術(shù)中右心功能具有一定價(jià)值。
[Abstract]:Purpose

1 . To evaluate the application value of omni - directional M - mode echocardiography in evaluating the right ventricular function in patients with mitral valve replacement .

2 . To analyze the correlation between omni - directional M - mode echocardiography and other ultrasonic quantitative techniques .

2 . Instrument : LEJ - 2 All - directional M - mode Echocardiogram System , with Echo PAC workstation equipped with GE - 7Dimension color echocardiography diagnostic instrument .

1 . Subjects : 30 patients in the control group and 58 patients with mitral valve replacement alone .

method

Methods : ( 1 ) The peak velocity of tricuspid annular systolic phase ( Sa ) was measured by quantitative tissue velocity imaging ( QTVI ) and LEJ - 2 omni - directional M - mode echocardiography ( OME ) .
Two - dimension ultrasonic - tracking imaging ( 2D - STI ) was used to measure the longitudinal peak strain ( S ) of the right ventricular myocardium in all subjects .
The peak velocity of each wall was measured by OME and anatomic M - mode echocardiography ( AMM ) . ( 2 ) The correlation between the peak velocity of tricuspid annular contraction and pulmonary arterial pressure ( PASP ) was compared between OME and QTVI , and between OME and 2D - STI measured values and between OME and AMM values .

Results

1 . The peak systolic velocity of tricuspid ring was increased before operation ( P0.01 ) .

2 . The peak velocity of tricuspid annuloplasty was negatively correlated with PASP ( r = - 0.85 , P0.01 ) .

3 . There was no significant difference between OME and QTVI ( P0.05 ) , and the correlation was good ( r = 0.94 , P0.01 ) . Correlation analysis showed good correlation between OME and 2D - STI measurements ( r = 0.95 , P0.01 ) . There was no significant difference in peak systolic velocity between OME and AMM ( P0.05 ) , and the correlation was good ( r = 0.81 , P0.01 ) .

Conclusion

All - directional M - mode echocardiography was able to evaluate the right ventricular function accurately and in real time . It can reflect the right ventricular function of the patients with mitral valve replacement . It is useful for cardiac surgeons and anesthesiologists . In the intraoperative monitoring , the right ventricular function in patients undergoing mitral valve replacement is of certain value .
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R540.45;R654.2

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本文編號：1961970