摘要
目的：报告我院2002年4月~2005年6月应用体表超声（TTE）对大动脉调转术治疗完全性大动脉转位（TGA）和右室双出口（DORV）Taussig-Bing心脏畸形的诊断研究及临床体会。方法：17例中男14例，女3例；年龄28小时~16岁；17例均有完整的临床、心电图（ECG）、超声及X线胸片资料。14例行心血管造影，3例仅凭TTE诊断，17例均经手术证实。17例中15例TGA，其中14例SDD型，1例SDL型；2例Taussig-Bing均为SDD型。15例TGA中8例室间隔完整，7例均合并动脉导管未闭（PDA）和房间交通，其中2例房缺（ASD），5例卵圆孔未闭（PFO），其中1例合并冠脉畸形，1例合并左室流出道阻塞。15例中7例合并室缺（VSD），其中5例合并肺动脉狭窄（PS），1例合并肺动脉高压（PH）和PDA；5例合并房间交通，其中2例ASD，2例PFO；1例PDA。2例Taussig-Bing均合并VSD及PH。使用仪器为日本东芝6000型和美国飞利浦IE33型彩色超声诊断仪，探头频率为2.5~3.75MHz。17例患者术前均用TTE诊断，术后均用TTE随访。结果：17例术前用TTE均准确诊断，TTE诊断符合率与手术符合率达100%，17例中16例手术成功，仅1例死亡。术后随访1个月至2年，TTE检出1例肺动脉上狭窄，其余均未异常血流。结论：超声TTE对大动脉调转术治疗TGA和DORV Taussig-Bing有一定的诊断价值，尤其是对适应证病例的选择，对指导手术方式有不可估量的作用。
Abstract
Objective: This paper reported the clinical experience of TTE used in studying switch procedure on patients with complete transposition of great arteries(TGA), double outlet of right ventricle(DORV) and Taussig-Bing anomaly from April 2002 to June 2005. Methods: Seventeen patients included 14 in male and 3 in female with age ranging from 6 hours to 16 years. All patients were correctly diagnosed by clinical data, ECG, TTE and X-ray, and finally confirmed by surgical procedure except 14 patients by angiocardiography and 3 patients by TTE. Of them, 15 patients were attributed to TGA, in which 14 patients being SDD type, 1 patient was divided as SDL type. And 2 patients with Taussig-Bing were confirmed as SDD type. In 15 patients with TGA, 8 patients had intact ventricular septum, others were complicated with patent ductus arteriosus(PDA) and communication between atriums, in which 2 patients being ASD and 5 patients being confirmed as patent foramen ovale(PFO), and other complications including anomaly of coronary artery in 1 patient and left ventricular outflow tract obstruction in 1 patient. Of the 15 patients, 7 patients were complicated with VSD, in which 5 patients with pulmonary stenosis(PS) and 1 patient having pulmonary hypertension(PH) and PDA, other complication in 1 patient. Two patients with Taussig-Bing were complicated with VSD and PH. Instrument routinely used in the study were Toshiba 6000 and Philips IE33 with probe frequency ranging from 2.5 to 3.75MHz. Results: All patients are correctly diagnosed by TTE. TTE is accorded with surgical finding. Of the 17 patients, 16 survived and only one died. During following-up for 1 month to 2 years with TTE, all 9 patients are in nomal dynamic function, except 1 patient had a super PS. Conclusion: TTE plays an important role in studying on arterial switch for TGA, DORV and Taussig-Bing anomalies, especially in surgical planning.
关键词
心脏缺损 /
先天性 /
超声心动描记术
Key words
heart defects /
congenital /
echocardiography
邓东安;侯传举;朱鲜阳;朱洪玉;汪曾炜.
超声心动图对大动脉调转术治疗完全型大动脉转位和Taussig-Bing的临床研究[J]. 中国临床医学影像杂志. 2007, 18(4): 257-258
DENG Dong-an;HOU Chuan-ju;ZHU Xian-yang;ZHU Hong-yu;WANG Zeng-wei.
Clinical study of echocardiography on surgical procedure for complete transposition of great artery and Taussig-Bing anomaly[J]. Journal of China Clinic Medical Imaging. 2007, 18(4): 257-258
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