肺动脉闭锁的超声心动图分析

目的 总结肺动脉闭锁的超声声心动图特点及诊断要点，提高对本病的诊断准确率。方法 回顾性分析36例经手术证实的肺动脉闭锁患者的超声心动图资料。结果 二维心动图各切面均不易显示发育不良的主肺动脉，联合运用彩色及连续波多普勒有助于对本病的诊断；依据室间隔完整性可将肺动脉闭锁分为室间隔完整型和室间隔缺损型：前者主动脉与肺动脉关系大多正常，后者动脉关系可转位或正常并易误诊为法洛四联征或右室双出口合并肺动脉狭窄，肺动脉血流主要来源于未闭动脉导管或（和）体肺侧支血管。结论 超声心动图可以确诊肺动脉闭锁。在超声探测中应注意观察肺动脉闭锁的水平、左右肺动脉有无融合、肺血管及右室发育状况、肺血来源以及合并其他心内畸形等，以便正确指导外科手术的筛选及术式选择。

Echocardiographic analysis of pulmonary atresia

Objective To improve the echocardiographic diagnostic accuracy of pulmonary atresia by summarizing its characteristics.Methods The data of two dimensional and Doppler echocardiography in 36 patients with pulmonary atresia confirmed by operation were analysed retrospectively.Results It was very difficult to show the dysplastic main pulmonary artery by two dimensional echocardiography in patients with pulmonary atresia, however color Doppler flow image and continue Doppler spectra could provide agreat help to detect them. The patients with pulmonary atresia could be divided into two categories based on their integrity of interventricular septum. The patients with pulmonary atresia and intact interventricular septum always had normal connection of great arteries. The patients with pulmonary atresia and ventricular septal defect could be with either normal or transposition of great arteries, which sometimes could be mistaken as tetralogy of Fallot or double outflow of right ventricle accompanied with pulmonary stenosis if neglecting their echocardiographic characteristics.Conclusions Pulmonary atresia can be diagnosed accurately by echocardiography. To assist operator to determine the operation approach and method, echocardiographic diagnosis should include following main points as the location of atresia, the convergence of left and right pulmonary arteries, the development of right ventricle and pulmonary vessel, the resource of pulmonary blood and other accompanied abnormalities.