肖婷婷,陈树宝,孙锟,黄美蓉,张玉奇,郭颖,张志芳.无创性评估肺血减少先天性心脏病肺血管的发育[J].中国医学影像技术,2007,23(6):855~857
无创性评估肺血减少先天性心脏病肺血管的发育
Noninvasive evaluation of pulmonary vascular development in congenital heart disease with decreased pulmonary blood flow
投稿时间:2006-11-23  修订日期:2007-05-03
DOI:
中文关键词:  超声心动描记术  Nakata指数  先天性心脏病
英文关键词:Echocardiography  Nakata index  Congenital heart disease
基金项目:
作者单位E-mail
肖婷婷 上海第二医科大学附属新华医院上海儿童医学中心,上海 200092 xjtt2000@lordor.com 
陈树宝 上海第二医科大学附属新华医院上海儿童医学中心,上海 200092  
孙锟 上海第二医科大学附属新华医院上海儿童医学中心,上海 200092  
黄美蓉 上海第二医科大学附属新华医院上海儿童医学中心,上海 200092  
张玉奇 上海第二医科大学附属新华医院上海儿童医学中心,上海 200092  
郭颖 上海第二医科大学附属新华医院上海儿童医学中心,上海 200092  
张志芳 上海第二医科大学附属新华医院上海儿童医学中心,上海 200092  
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中文摘要:
      目的 探求一种无创性评估肺血管发育情况的方法。方法 采用112例肺血减少患者的数字减影心血管造影及超声心动图像,分别多点测量肺动脉近端、远端,将造影与超声所测结果进行相关分析;并将超声所测左、右肺动脉远端截面积之和/体表面积(EPAI)与术后情况进行相关分析。结果 心血管造影与超声心动图测量结果高度相关,肺动脉总干r=0.79,左肺动脉近端r=0.73,右肺动脉近端r=0.77,左肺动脉远端r=0.69,右肺动脉远端r=0.89。EPAI与术后监护时间,呼吸机维持时间,正性肌力药物用量相关。EPAI≤115 mm2/m2时,血流动力学很不稳定,低心排发生率与死亡率明显增加。结论 EPAI是无创性评估肺血管发育及肺血流情况的良好指标,能为外科手术方案的选择提供有效依据。
英文摘要:
      Objective To seek a new method for noninvasive estimation of pulmonary artery. Methods Pulmonary artery diameters were measured at proximal, middle, distal portions on DSA and tapes of echocardiography in 112 patients with congenital heart disease with decreased pulmonary blood flow. The correlation was analyzed between the results of echocardiography and angiocardiography. The correlative analysis was done between echocardiography pulmonary artery index (EPAIs) and postoperative outcome. Results Excellent correlations between echocardiography and angiocardiography were obtained (the main pulmonary artery: r=0.79, proximal portion of the left pulmonary artery: r=0.73, proximal portion of the right pulmonary artery: r=0.77, distal portion of the left pulmonary artery: r=0.69, distal portion of the right pulmonary artery: r=0.89). The length of day in ICU, mechanical ventilation time, dose of inotropic drugs correlated well with EPAI, when EPAI≤115 mm2/m2, postoperative hemodynamics was unstable, the frequency of low cardiac output syndrome and mortality significantly increased. Conclusion EPAI is an excellent morphological indicator of pulmonary blood flow and development status of pulmonary vessels. It may improve the decision-making strategy.
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