经胸超声心动图术前及术中指导房间隔缺损封堵术.pdfVIP

268 中国越卢医学杂志2002年 第】8卷第4期 Chinese J Ultra ound o ! 经胸超声心动图术前及术中指导房间隔缺损封堵术 张军 张玉顺 姚志勇 李军 代政学 李寰 摘 要 目的：评价经胸超声心动图(TTE)术前测量房间隔缺损 (ASD)大小丑术中监测ASD封堵的作用。 方涪：6O例ASD患者，年龄 1 17～65(25．O二18 6)岁。术前用HP Sonos1500皿5500型彩色多普勒超声诊断仪 经胸测量各切面ASD大小豆周缘情况，经心导营ASD封堵术中TTE监测封堵过程、伞释出后牢固程度及彩色多普 勒有无分流。结果：用TTE术前检查ASD大小2～36(17．8二7 3)nlnl，选用ASD封堵器大小为5～40 L22 9士 8 D)ITIITI。超声测量ASD大小与封堵器大小相关良好一 0．g4(P-~O．0011。硬缘ASD的封堵器选择比超声所测 ASD大 l～6ram 软缘ASD通常不考虑摆动较大部分为有效缘丽予 去除．封堵器选择比超声所襁j ASD大7～ 13ram不等。所有封堵器封堵牢固，无脱落。结论：TTE术前检查丑术中指导ASD封堵是一种可行、有效、简便的 方法。缺损较大、边缘较短或TTE不易显示清楚的薄缘ASD应进行术中经食道超声监测． 关键词 超声心动图 房间隔缺损 封堵 Guidance of Atrial Septal Defect Occlusion by Using Transthoraeie Ecbocar dj0graphy Before and During Operation Zhang Jun，Zhang Yushun，Yao Zhiyong，et al Xijing Hospita1．Fourth Military bledical University Xi’an 710032 China ABSTRACT Objective：T0 evaluate the value of transthoracic ech0cardl。graphy(TTE)on ille~surelllent atria1 septal defect(ASD)before occlusion and monitoring ASD occlusion during operation．Methods：Sixty．patients with ASD，age rangedfroml 17to 65(25．0±18．6)year，~-ere occluded by usingtranseatheter occluder．The ASD size and edges in various sections were measured by use of TTE with HP Sonos 1530 and 5500 Color Doppler systems Operation of occlusion，firmness of umbrellas and residual shunt％vere monitored and detected by TTE Results：Size olASD measured by TTEwere 2～36(17．8士7 3)lnlil before operation．Selected occluder x~,ere 5～40(22．9± 8．0)111111 Close correlation w85 found between the size of ASD measured by TTE and the size ol occluder，r一0．94 (P0 001) The occluder size was 1～6rnrn larger than ASD size in solid edge ASD．But occluder size 7～l3mm larger than ASD size