实时三维超声心动图在鲁登巴赫综合征联合介入治疗中的应用.docVIP

实时三维超声心动图在鲁登巴赫综合征联合介入治疗中的应用 　　广东省高州市人民医院超声科，广东高州 525200 　　[摘要] 目的 探讨实时三维超声心动图（real-time three-dimensional echocardiography，RT-3DE）在鲁登巴赫综合征联合介入治疗术前、术中的应用价值。 方法 对12例确诊鲁登巴赫综合征的患者进行联合介入治疗，在术前应用RT-3DE对房间隔缺损（ASD）及二尖瓣进行观察、测量；术中以RT-3DE指引完成二尖瓣球囊扩张术及ASD封堵术；术前、术后测量的参数有二尖瓣口面积（MVA）、右房左右径（RAD）、肺动脉收缩压（PAPs）、二尖瓣反流量（Mi）。 结果 通过RT-3DE观察，12例鲁登巴赫患者术后ASD封堵器固定，与术前比较，MVA明显扩大，RAD回缩，PAPs下降[分别为（1.80±0.18）cm2比（1.02±0.16）cm2，（40.32±3.11）mm比（48.33±3.24）mm，（44.06±9.12）mm Hg比（57.57±10.33）mm Hg，均P 0.05]。 结论 RT-3DE辅助之下的联合介入术是治疗鲁登巴赫综合征的安全有效的方法。 　　[关键词] 三维超声心动图；鲁登巴赫综合征；联合介入治疗 　　[中图分类号] R815 [文献标识码] A [文章编号] 1673-7210（2014）03（a）-0085-03 　　Application of real-time three-dimensional echocardiography in combined interventional therapy of Lutembacher′s syndrome 　　YE Fuyong LIANG Junqiang LIN Xiaochun 　　Department of Ultrasound， Gaozhou Peoples Hospital， Guangdong 525200 　　[Abstract] Objective To investigate the preoperative and intraoperative clinical value of real-time three-dimensional echocardiography （3DE） in the combined interventional therapy of lutembacher′s syndrome. Methods Combined interventional therapy was performed on 12 patients with Lutembacher′s syndrome. Before the operations， patients′ASD and mitral valve were observed and measured by means of RT-3DE. During the operation， the mitral valve ballon dilation and ASD closure were completed with the guidance of RT-3DE. The preoperative and intraoperative statistics included the mitral valve area （MVA）， right atrium diameter （RAD）， pulmonary arterial systolic pressure （PAPs） and mitral regurgitation （Mi）. Results By observing with RT-3DE， the ASD occluder devices were fixed in the 12 patients with Lutembacher′s syndrome after operations. Compared with the condition before the operations， their MVA enlarged apparently， RAD rebounded， PAPs decended [respectively from （1.80±0.18） cm2 to （1.02±0.16） cm2， （40.32±3.11） mm to （48.33±3.24） mm， （44.06±9.12） mm Hg to （57.57±10.33） mm Hg， P 0.05]. Conclusion With the help of RT-3DE， combined