【摘要】 目的 :采用经胸和食道超声探查中老年人房间隔缺损 (ASD)的大小 ,血流动力学变化情况 ,进一步探讨房缺对人体的影响 ,更好地指导治疗。方法 :4 0例中老年房缺患者 ,均行经胸与食道超声检查。取心尖四腔心 ,大动脉短轴切面 ,食道超声注意观察房缺距上下腔静脉入口处的距离 ,距二尖瓣的距离等 ,测量缺损大小 ,右室内径 ,过隔血流速度 ,肺动脉血流速度 ,三尖瓣关闭不全程度。结果 :本组患者 4 0～ 78岁 ,平均 5 1.4岁 ,经胸超声测量房缺大小为14～ 4 7mm,平均 33.0 mm ;右室内径 31～ 6 6 mm,平均 4 0 .1mm ;肺动脉内径 2 6～ 4 8mm ,平均 36 .5 mm;肺动脉血流速度 6 6～ 35 0 cm /s,平均 183.9cm /s;左向右分流舒张期速度 4 8～ 14 0 cm /s,平均 85 .9cm/s;三尖瓣返流速度 2 0 0～4 30 cm/s,平均 318.5 cm/s;经食道超声检查房间隔缺损大小平均为 37.0 mm;手术和术中球囊测量房缺内径平均38.0 mm。结论 :通过本组房缺病例经胸和食道超声检查并与手术对照 ,阐明了房缺患者在决定手术治疗时应该采用彩超经食道检查 ,根据确切的大小、部位和血流动力学变化程度决定治疗时机和选择治疗方式。更多还原

【Abstract】 Objective:To explore the value of multiplane transesophageal echocardiography(MTEE) in diagnosing atrial septal defects(ASD) in middle-aged and aged people treated by the Amplatzer septal occluder(ASO).Methods:Transthoracic echocardiography(TTE) and MTEE were performed on 40 cases with ASD in adults.The location,the defect size,the diameter of right ventricle(RV),the velocity of tricuspid insufficiency(TI),pulmonary artery (PA)and the left to right shunt,the degree of TI were assessed in apical four chamber view and aortic root short axis view.Results:MTEE can well display the morphological changes and blood dynamics.In this group,the median age was 51 years (ranging from 40 to 78 years).The mean defect was 33 mm(ranging from 14 to 47 mm)measured by TTE vs 37 mm measured by MTEE and 38 mm by operation respectively.The diameter of RV was 40 mm(ranging from 31 to 66 mm).The diameter of PA was 36.5 mm(ranging from 26 to 48 mm).The velocity of left to right shunt,TI and PA was 86 cm/s(ranging from 48～140 cm/s),184 cm/s(ranging from 66～350 cm/s) and 318.5 cm/s(ranging from 200～430 cm/s) respectively.Conclusions:MTEE is important in diagnosing ASD,especially in displaying the location,the defect size and selecting the operation means.更多还原