应用二维超声心动图和三节段概念诊断复杂先天性心脏病

目的 将心脏解剖三节段概念引入二维超声心动图（２ＤＥ）诊断复杂先天性心脏病（先心病）中，使２ＤＥ诊断复杂先心病简单化，条理化。方法 应用２ＤＥ对９２０例复杂先心病根据心脏解剖三节段概念进行分型诊断，８２２例心血管造影对照，５８４例手术证实。结果 根据心脏解剖三节段概念其中心房正位８５５例（包括８９例永存左上腔静脉和３１例完全肺静脉异位引流）、心房反应５３例、心房不定位１２例；２组房室瓣开放７４７例、一侧房室瓣闭锁１１２例、一组共同房室瓣６１例；心室右袢６０６例、心室左袢１１１例、单心室２０３例（包括２４例双腔心）；大动脉关系正常位３２例、永存动脉干２５例。２ＤＥ诊断正确８２３例，总诊断准确率８９．５％。结论 将心脏解剖三节段概念引入２ＤＥ诊断复杂先心病，对心脏逐节段分析可诊断简单化，条理化，为心脏外手术提供简单明确的诊断依据。

Diagnosing complicated congenital heart disease with two-dimensional echocardiography and three-segment concept

Objective To apply three-segment heart anatomy concept to two-dimensional echocardiography (2DE) in the diagnosis of complicated congenital heart disease (CHD). Methods 920 cases of CHD were diagnosed with 2DE and three-segment heart anatomy concept. 822 out of the 920 cases underwent angiocardiography, and 584 cases were confirmed by operation. Results According to three-segment heart anatomy concept of atrial position, 855 cases were situs solitus (including 89 cases of left superior vena cava and 31 cases of complete anomalous pulmonary venous drainage), 53 cases were situs inversus, and 12 cases were situs ambigus. As to atrial-ventricular valve, 747 cases were both opening, 112 cases had one-side atresia, and 61 cases had one together valve; As to ventricle position, 606 cases were dextro-loop, 111 cases had levo-loop, and 203 cases had single ventricle (including 24 cases), As to cor biloculare of great artery relation, 304 cases had normal relation of great arteries, including 35 cases of pulmonary atresia, 219 cases had right-transposition of great arteries, 240 cases had left-transposition of great arteries, 32 cases were mirror to normal, and 25 cases had persistent truncus arteriosus. 823 cases were diagnosed with 2DE, with a total accurate rate of 89.5%. Conclusion Applying three-segment heart anatomy concept to 2DE to diagnose complicated CHD and analyzing the heart segment by segment will make the diagnosis simple and systematic, providing a concise basis for heart surgeries.