摘要
目的:调查法洛四联症心内直视根治术后的远期疗效,研究跨肺动脉瓣环手术方法对预后的影响,对比心脏彩超及心脏核磁共振(CMR)评价术后心脏功能的差别,为进一步改善预后及监测提供理论依据。方法:全组58例,随访10～17年,平均12.3年,调查患者基本情况、手术前后的心功能情况(包括症状、体征、心电图、胸片、心脏彩超和CMR等)以及手术情况。结果:全组病例心功能Ⅱ级以上占24.1%,但是心脏彩超及CMR检查显示有89.7%的患者右心室扩大,右心室功能下降者占40%,肺动脉瓣中-重度反流占51.7%左右,显示法洛四联症术后远期心功能减退;跨肺动脉瓣环补片组右心室舒张末期容积指数(RV-EDVI)、右心室收缩末期容积指数(RV-ESVI)、前向肺动脉瓣血流容量均比非跨肺动脉瓣环补片组高;心脏彩超Tei指数及收缩时间间期(STI)评价右室功能,与CMR射血分数(EF)差异无统计学意义。结论:法洛四联症远期随访显示有右心室扩大、右心室心功能减退和肺动脉瓣反流,应建立长期随访机制密切随访;跨肺动脉瓣补片对心功能的影响有待进一步观察;心脏彩超采用Tei指数及STI评价术后患者心功能与CMR检查评价一致。
Objective：To investigate the long-term results of correction of tetralogy of Fallot, analyze the influ ence of transannular patchs on outcomes and study the different variables on cardiac function performed by echo- cardiography and cardiac magnetic resonance imaging （CMR）. Method： Fifty-eight children with tetralogy of Fallot repaired before January 1998 were sampled and divided transannular patch group and non transannular patch group. The basic conditions besides the health status before and after operation such as cardiac function, echocar- diography, CMR, electrocardiogram and the methods of operation were investigated. Result：The follow range were 10-17 years and mean follow years was 12.3. Cardiac function beyond NYHA II was 24.1%, right ventricular （RV） dilation occupy was 89.7%, pulmonary regurgitation （PR） was 51.7% and right ventricle ejection fraction （RV-EF） 440% was 40%. The health condition was not satisfied. The values of right ventricle end diastolic volume index （RV-EDVI）, right ventricle end systolic volume index （RV-ESVI） and forward pulmonary flow volume in transannular patch group were higher than those in nontransannular patch group. Tei index and systolic time interval （STI） have no statistics difference respectively compared with CMR EF. Conclusion： Long-term repaired tetralogy of Fallot may suffer from RV dilation, RV dysfunction, significant PR. Transannular patch has influenced RV-EDVI, RV-ESVI and forward pulmonary flow volume. Tel index and STI have equal effect compared with CMR EF evaluated on repaired tetralogy of Fallot.
出处
《临床心血管病杂志》
CSCD
北大核心
2013年第8期618-620,共3页
Journal of Clinical Cardiology
基金
国家“十一五”科技支撑计划课题(No:2007BAI05B03)
关键词
法洛四联症
超声心动图
核磁共振
心功能
tetralogy of Fallot
echocardiography
magnetic resonance imaging
cardiac function
