摘要
目的 :探索能更好地评估肺血管发育情况的新方法 ,为确定法乐四联症 (TOF)手术指征提供依据。方法 :采用 118例TOF患者的数字减影心血管造影胶片 ,用计算机辅助测量系统自动测量左、右肺动脉近、中、远端直径 ,分别计算Nakata指数 (PAI)、McGoon指数、改良PAI,再与术后情况进行相关分析。结果 :测量结果表明右肺动脉内径的最小值位于近端者有 6 2例 ,位于中部者 2 2例 ,位于远端者34例 ;而左肺动脉内径的最小值位于近端者有 4 6例 ,位于中部者 13例 ,位于远端者 5 9例 ;改良PAI与术后监护时间 ,呼吸机维持时间 ,正性肌力药物用量的相关性比PAI更高 ,PAI与术后情况的相关性比Mc Goon指数更高。改良PAI≤ 12 0mm2 m2 时 ,血液动力学很不稳定 ,低心排发生率与死亡率明显增加 ,术后综合情况差。结论
Objective:To explore a new method for evaluating the development of pulmonary arteries,as a criterion for TOF operation.Method:Pulmonary arteries were quantified by McGoon index,PAI and modified PAI at proximal,middle,distal portions on DSA films with compute assisted measurement system in 118 patients with TOF.The correlative analysis was done between PAIs and postoperative outcome.Result:The minimal diameter was found at proximal RPA in 62 cases,at middle portion in 22 cases and at distal protion in 34 cases;the minimal diameter was found at proximal LPA in 46 cases,at middle portion in 13 cases,at distal protion in 59 cases.Compared with Nakata index,the length of day in ICU,mechanical ventilation time,dose of inotropic drugs correlated well with modified PAI more than PAI.Compared with McGoon index,the postoperative situation correlated well with PAI.When modified PAI≤120 m\+2/m\+2,postoperative hemodynamics was made unstable,the frequency of low cardiac output syndrome and mortality were increased. Conclusion:Modified PAI was very useful in decision\|making strategy of TOF and predicting postoperative outcome.
出处
《心肺血管病杂志》
CAS
2002年第1期26-28,共3页
Journal of Cardiovascular and Pulmonary Diseases
