B-TDE在ICU評價心臟瓣膜置換術(shù)后PASP的準確性研究
發(fā)布時間：2018-08-14 16:53
【摘要】：目的評價床邊經(jīng)胸多普勒超聲心動圖（bedside transthoracic dopplerechocardiography，B-TDE）在重癥監(jiān)護室（intensive care unit，ICU）對心臟瓣膜置換術(shù)后患者估測肺動脈收縮壓（pulmonary artery systolic pressure，PASP）的準確性。 方法72例心臟瓣膜置換術(shù)后患者，術(shù)前放置右心導管，術(shù)后48小時內(nèi)在ICU同時接受B-TDE和右心導管兩種方法對PASP測量。將兩種方法所測得PASP結(jié)果差異進行分析。 結(jié)果在72例受試對象中，其中主動脈瓣置換術(shù)后12例，二尖瓣置換術(shù)后38例，雙瓣置換術(shù)后22例；右房（四腔心切面）前后徑50mm者28例。兩種方法所得PASP按主動脈瓣置換術(shù)后（A組）、二尖瓣置換術(shù)后（B組）及雙瓣置換術(shù)后（C組）分組進行t檢驗，A組B-TDE (35±12)mmHg VS右心導管(36±16)mmHg，P=0.765，B組B-TDE (38±13)mmHg VS右心導管(36±14)mmHg，P=0.705，C組B-TDE(38±14)mmHg VS右心導管(40±12)mmHg，P=0.685，兩種方法在A、B、C三組中測定PASP結(jié)果差異均無統(tǒng)計學意義(1mmHg=0.133kPa)。 分別對右房（四腔心切面）前后徑50mm者與右房（四腔心切面）前后徑50mm者兩種方法所得PASP進行t檢驗，右房（四腔心切面）前后徑50mm者B-TDE(38±11)mmHg VS右心導管(38±12)mmHg，P=0.852，右房（四腔心切面）前后徑50mm者B-TDE(37±14)mmHg VS右心導管(37±14)mmHg，P=0.474，對于不同的右房大小患者兩種方法測定PASP結(jié)果差異無統(tǒng)計學意義。Pearson相關(guān)分析顯示B-TDE與右心導管測量的PASP呈中度相關(guān)，A組r=0．64，P0．05，B組r=0．68，P0．05，C組r=0．61，P0．05。BTDE與右心導管測量PASP差值在10mm Hg以上者31例(43.0％)，其中BTDE低于右心導管測量者22例(30.5％)，高于右心導管測量者9例(12.5％)。 結(jié)論心臟瓣膜置換術(shù)后患者在ICU經(jīng)B-TDE測量PASP與右心導管法測定的PASP差異性均無統(tǒng)計學意義，兩種方法在所有受試患者中測定的PASP呈中度相關(guān)。B-TDE在ICU對于心臟瓣膜置換術(shù)后患者可快速提供可靠的PASP資料。
[Abstract]:Objective to evaluate the accuracy of (bedside transthoracic Doppler echocardiography B-TDE in estimating pulmonary arterial systolic pressure (pulmonary artery systolic) after cardiac valve replacement in (intensive care unit of intensive care unit (ICU). Methods right cardiac catheters were placed in 72 patients after cardiac valve replacement. Both B-TDE and right cardiac catheterization were used to measure PASP in ICU within 48 hours after operation. The differences between the PASP results obtained by the two methods were analyzed. Results there were 12 cases after aortic valve replacement, 38 cases after mitral valve replacement, 22 cases after double valve replacement, and 28 cases with right atrium (four-chamber view) anterior diameter 50mm. PASP obtained from two methods were divided into three groups: after aortic valve replacement (group A), after mitral valve replacement (group B) and after double valve replacement (group C). T test was performed in group A (35 鹵12) mmHg VS), right cardiac catheterization (36 鹵16) mm, B-TDE (B-TDE) (38 鹵13) mmHg VS), right ventricular catheterization (36 鹵14) mm, right cardiac catheterization 0.705 B-TDE (38 鹵14) mmHg VS). There was no significant difference (1mmHg=0.133kPa) between the two methods in the determination of PASP in the three groups. T test was performed on the PASP obtained by the two methods: the right atrium (four-chamber section) anterior diameter 50mm and the right atrium (four-chamber central section) anteroposterior diameter 50mm. B-TDE (38 鹵11) mmHg VS) and 50mm (37 鹵14) mmHg VS) with anterior and posterior diameter of right atrium (50mm) were found in B-TDE (38 鹵11) mmHg VS) and B-TDE (37 鹵14) mmHg VS), respectively. There was no significant difference in PASP results between the two methods in patients with different right atrial sizes. The results of PASP in patients with right atrium diameter were (38 鹵12) mm, (38 鹵12) mm, and (0.852) mm, respectively, while those with 50mm were (37 鹵14) mmHg VS, (37 鹵14) mm, respectively. There was no significant difference between the two methods in detecting PASP in patients with different right atrial sizes. Pearson correlation analysis showed that there was a moderate correlation between B-TDE and PASP measured by right cardiac catheterization in 31 cases (43.0%) whose PASP difference between right cardiac catheterization and B-TDE was above 10mm Hg, and BTDE was lower than that of right cardiac conduction in group A (n = 0.68) and group C (n = 0.05). 22 cases (30.5%) were measured by tube, which was higher than that of 9 cases (12.5%) by right cardiac catheterization. Conclusion there was no significant difference in PASP between PASP and right cardiac catheterization in ICU after cardiac valve replacement. The PASP measured by both methods in all subjects showed moderate correlation. B-TDE could provide reliable PASP data for patients after cardiac valve replacement with ICU.
【學位授予單位】：安徽醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R654.2;R540.45
本文編號：2183506
[Abstract]:Objective to evaluate the accuracy of (bedside transthoracic Doppler echocardiography B-TDE in estimating pulmonary arterial systolic pressure (pulmonary artery systolic) after cardiac valve replacement in (intensive care unit of intensive care unit (ICU). Methods right cardiac catheters were placed in 72 patients after cardiac valve replacement. Both B-TDE and right cardiac catheterization were used to measure PASP in ICU within 48 hours after operation. The differences between the PASP results obtained by the two methods were analyzed. Results there were 12 cases after aortic valve replacement, 38 cases after mitral valve replacement, 22 cases after double valve replacement, and 28 cases with right atrium (four-chamber view) anterior diameter 50mm. PASP obtained from two methods were divided into three groups: after aortic valve replacement (group A), after mitral valve replacement (group B) and after double valve replacement (group C). T test was performed in group A (35 鹵12) mmHg VS), right cardiac catheterization (36 鹵16) mm, B-TDE (B-TDE) (38 鹵13) mmHg VS), right ventricular catheterization (36 鹵14) mm, right cardiac catheterization 0.705 B-TDE (38 鹵14) mmHg VS). There was no significant difference (1mmHg=0.133kPa) between the two methods in the determination of PASP in the three groups. T test was performed on the PASP obtained by the two methods: the right atrium (four-chamber section) anterior diameter 50mm and the right atrium (four-chamber central section) anteroposterior diameter 50mm. B-TDE (38 鹵11) mmHg VS) and 50mm (37 鹵14) mmHg VS) with anterior and posterior diameter of right atrium (50mm) were found in B-TDE (38 鹵11) mmHg VS) and B-TDE (37 鹵14) mmHg VS), respectively. There was no significant difference in PASP results between the two methods in patients with different right atrial sizes. The results of PASP in patients with right atrium diameter were (38 鹵12) mm, (38 鹵12) mm, and (0.852) mm, respectively, while those with 50mm were (37 鹵14) mmHg VS, (37 鹵14) mm, respectively. There was no significant difference between the two methods in detecting PASP in patients with different right atrial sizes. Pearson correlation analysis showed that there was a moderate correlation between B-TDE and PASP measured by right cardiac catheterization in 31 cases (43.0%) whose PASP difference between right cardiac catheterization and B-TDE was above 10mm Hg, and BTDE was lower than that of right cardiac conduction in group A (n = 0.68) and group C (n = 0.05). 22 cases (30.5%) were measured by tube, which was higher than that of 9 cases (12.5%) by right cardiac catheterization. Conclusion there was no significant difference in PASP between PASP and right cardiac catheterization in ICU after cardiac valve replacement. The PASP measured by both methods in all subjects showed moderate correlation. B-TDE could provide reliable PASP data for patients after cardiac valve replacement with ICU.
【學位授予單位】：安徽醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R654.2;R540.45
【參考文獻】
相關(guān)期刊論文 前10條
1 郭燕麗,張紹祥,劉正津,譚立文,李銳;國人可視化心臟在多平面經(jīng)食道超聲心動圖診斷風濕性心臟瓣膜病中的應用價值[J];第三軍醫(yī)大學學報;2004年16期
2 張建立;張環(huán)宇;楊倍;金有靚;;超聲心動圖法測定先天性心臟病肺動脈收縮壓的可靠性研究[J];臨床醫(yī)學;2008年09期
3 李艷;;彩色多普勒超聲用于老年退行性心臟瓣膜病診斷中的臨床觀察[J];當代醫(yī)學;2012年27期
4 宋艷;錢蘊秋;張海濱;何光彬;劉麗文;李紅玲;田雪;朱永勝;;老年鈣化性心臟瓣膜病的超聲心動圖表現(xiàn)[J];解放軍醫(yī)學雜志;2006年05期
5 趙博文,鮑德國,潘孔寒,范曉明,湯富剛,范妙英,壽金朵,呂江紅,徐海珊,冼棠超;床邊彩色多普勒超聲心動圖在急診及ICU/CCU中的應用價值[J];中華急診醫(yī)學雜志;2002年03期
6 潘敏;劉俐;蔡有利;王雙雙;陳蕓;;床邊超聲心動圖檢查在首診心血管急危重癥中的應用價值[J];臨床心血管病雜志;2012年04期
7 朱天剛,張紅,劉美貞,潘詠梅,閻小娣,周惠清,楊松娜;床邊超聲心動圖在危重和急癥心血管疾病中的應用價值[J];內(nèi)科急危重癥雜志;2004年02期
8 南曉彥;孫幼屏;娜日蘇;劉曉平;;經(jīng)胸及食道超聲心動圖對人工心臟瓣膜的綜合評估及其意義[J];內(nèi)蒙古醫(yī)學雜志;2011年09期
9 武秀華;沈策;;無創(chuàng)正壓通氣對慢性阻塞性肺病患者肺動脈壓的作用[J];臨床肺科雜志;2012年07期
10 文斌;;超聲心動圖診斷肺動脈高壓157例分析[J];臨床肺科雜志;2013年07期
，本文編號：2183506
本文鏈接：http://sikaile.net/yixuelunwen/fangshe/2183506.html
最近更新
教材專著
