摘要
目的:总结心上型完全性肺静脉异位引流(TAPVC)超声心动图的诊断特点及对围术期临床转归的指导意义。方法:对2010年6月至2015年6月5年间我院儿童心脏中心收治的心上型TAPVC患儿的超声心动图及临床资料进行回顾性分析。结果:经超声心动图诊断并外科手术证实为心上型TAPVC 69例,男性46例,女性23例,中值年龄5.0个月(21d^180个月)。69例术前超声心动图诊断均与手术诊断一致,符合率100%。设定超声测量房间隔交通≤5mm为限制性房间隔交通(限制性房水平分流)。本组研究提示限制性房间隔交通组就诊年龄(P=0.005)、体表面积(P=0.015),经皮血氧饱和度(P=0.039),房间隔交通直径指数(P<0.001)等均明显低于房间隔交通直径>5mm患儿组(非限制性分流);而肺动脉收缩压(P=0.002),右心室舒张末径指数,右心室与左心室前后径比值则明显高于非限制性分流组(P<0.001),且术后ICU时间明显长于非限制性分流组(P=0.01)。结论:超声心动图是诊断心上型TAPVC首选且准确的方法。心上型TAPVC尽早诊断手术预后良好。房水平分流大小,引流血管是否梗阻,术前右心室与左心室内径比值与心上型TAPVC患儿围术期转归密切相关。
Objective： We aim to summarize the echocardiographic features and estimate its clinical impacts on perioperative outcomes in a group of supracardiac total anomalous pulmonary venous connection （TAPVC） pediatric patients. Methods： We retrospectively studied patients who underwent surgical repair for supracardiac TAPVC between 2010-2015. Echocardiographie and clinical data were collected before and early after the surgery. Patients with concomitant complex cardiac defects or without surgical procedures were excluded. Interatrial communication ≤5mm was defined as atrial septal restriction. Results： 69 patients （46 males and 23 females） were diagnosed by echocardiography and underwent TAPVC repair at a median age of 5.0 months （21 days to 15 years） at our center. The consistent rate of echocardiography with surgery was 100% in diagnosis of supracardiac TAPVC, 97.1% in identification of the exact connection site. Compared with the patients with non-restricted atrial shunt （ 〉 5mm）, the median age, body surface area（ BSA）, transcutaneous hemoglobin saturation, and interatrial communication diameter indexed by BSA in patients with atrial septal restriction were significantly lower（ P 〈 0. 05 for all） ; whereas pulmonary systolic pressure, right ventrieular end diastolic diameter indexed by BSA, the right ventricular to left ventricular diameter ratio at end-diastole （ RV/ LV ratio） was significantly higher（ P 〈 0.01 for all） , also ICU stay was longer in patients with atrial septal restriction （P = 0.011 ）. Conclusion： Echocardiography is the primary and accurate diagnostic method in patients with supracardiac TAPVC. Interatrial communication diameter indexed by BSA, preoperative pulmonary venous obstruction, and RV/LV ratio was associated with adverse perioperative outcomes.
出处
《心肺血管病杂志》
2017年第1期14-17,共4页
Journal of Cardiovascular and Pulmonary Diseases
关键词
超声心动图诊断
完全型肺静脉异位引流
心上型
Echoeardiographicdiagnosis
Total anomalous aulmonary venous connection, Supracardiac
