新生儿先天性心脏病的超声心动图应用价值研究

目的 探讨新生儿先天性心脏病的超声心动图应用价值.方法 选择2005年1月-2011年1月新生儿500例,筛查新生儿先天性心脏病发病情况并进行分析.结果 本组患儿中77.5%是常见类型中的左向右分流畸形,右向左分流者占11.3%,肺动脉出口梗阻者占4.2%,左室流出道梗阻者占3.2%.结论 重视新生儿先天性心脏病的检查可早期发现先心病,以便及时治疗和预防并发症.     

新生儿先天性心脏病130例分析

先天性心脏病(CHD)是小儿最常见的心血管疾病之一,目前我国每年约有10～15万患有CHD的婴儿出生,部分严重、复杂的心血管畸形患儿如生后得不到及时、正确的诊治将很快夭折。为了更好的防治CHD,减少新生儿及婴幼儿死亡率。本文对我院新生儿科2000年1月～2004年8月收治的经彩色多普勒超声心动图(CDFI)和尸解确诊的CHD 130例分析如下。     

先天性心脏病超声心动图筛查结果分析

先天性心脏病已成为我国5岁以下儿童死亡的主要原因[1]。为了能早期发现、早期干预、早期治疗,提高先天性心脏病儿童的生命质量,用超声心动图对新生儿进行先天性心脏病筛查非常必要。本院将新生儿超声心动图检查列入常规检查项目,现将本院部分新生儿先天性心脏病筛查结果报道如下:     

200例先天性心脏病的彩色多普勒超声心动图诊断的分析

目的 分析200例先天性心脏病彩色多普勒超声心动图的资料,提高临床医师对先天性心脏病的认识,以便指导临床合理的检查与治疗.方法 对200例临床疑诊先天性心脏病患者应用彩色多普勒超声心动图进行多切面扫查,观察心脏各房室大小,判定有无肺动脉高压形成等.结果 200例先天性心脏病患者中,年龄6～68岁,男89例,女儿1例;18岁以下者54例(27%),18～44岁者115例(58%),45岁以上者31例(15%).房间隔缺损62例,室间隔缺损55例,动脉导管未闭19例,室间隔膨出瘤15例,其他类型先天性心脏病49例.47例进行经食管超声(TEE)检查.38例患者进行了手术或介入治疗.结论 彩色多普勒超声心动图能够准确诊断各种类型的先天性心脏病,有助于临床进行介入和手术治疗.     

先天性心脏病的超声心动图诊断

随着科学技术的发展，先天性心脏病（先心病）的超声心动图诊断技术发展迅速。熟悉并合理应用先心病诊断技术将对提高先心病诊断治疗水平有重要意义。     

胎儿超声心动图对先天性心脏病的诊断价值

1997年 10月至 2 0 0 0年 6月我院超声科应用彩超仪检查 46例正常孕妇胎儿和 9例高危孕妇胎儿 ,现报告如下。1　材料与方法1.1　孕妇资料46例正常孕妇 ,年龄 2 2～ 3 2岁 ,平均年龄 2 9.5岁 ,检查时孕周 17～ 42周 ,平均 2 4.6周。 9例高危孕妇 ,年龄 2 8～ 3 6岁 ,平均年龄 3 1.7岁 ,检查时孕周 2 5～ 42周 ,平均 2 8.7周。1.2　检查方法仪器为 ATL 公司 HDI-3 0 0 0彩超仪 ,探头 3 .5 MHz及5 .0 MHz。孕妇取平卧位或左侧卧位 ,应用二维超声结合彩色多普勒明确胎儿心脏解剖结构 ,判断各房室、大血管位置和房室瓣结构有无异常 ,对结构异…     

脉冲多普勒超声心动图诊断先天性心脏病的临床价值

脉冲多普勒超声心动图(PDE)的临床应用,提高了超声诊断先心病的敏感性和特异性,对于心血管内血流状态的观察和血流紊乱的确定具有重要的价值。为证实之,本文将我院近年来经PDE检查并手术证实的46例先天性心脏病作一临床分析。     

新生儿先天性心脏病超声早期筛查的临床价值探讨

目的探讨应用彩色多普勒超声对新生儿先天性心脏病进行早期筛查的临床价值。方法对在我院新出生的5536例新生儿进行超声心动图常规检查,检查结果统一分析。结果超声心动图诊断先天性心脏病181例,其中以非紫绀型常见,168例,占93.3%;紫绀型11例,占6.01%。结论彩超筛查新生儿先天性心脏病对于早期诊断和治疗新生儿先天性心脏病具有重要的临床意义。     

动态三维超声心动图诊断先天性心脏病的进展

三维超声心电图是晚近发展起来的无创检查技术,可以对心脏进行任意切割、旋转,从不同方向实时显示心脏与大血管的空间关系及其活动状况。目前,该技术已从实验阶段进入临床阶段,将对先心病的临床诊断发挥重要作用。     

应用超声心动图大规模筛查儿童先天性心脏病

第6届中13德三国联合国际心血管病学术研讨会——心血管病,心脏内外、科进展,于2010年6月26～27日在天津泰达国际心血管病医院召开。这次会议由中、日、德三国心血管内外科、麻醉科、体外循环、心血管诊断影像学数十位专家做了有关专业领域内最新进展的专题报告,涵盖冠心病、心脏瓣膜疾病、先天性心脏病、心脏移植及辅助装置、心律失常、心衰治疗,以及心血管外科手术、麻醉及体外循环等多个领域。这次刊出会议论文摘要选编精华,以帮助心血管专业同道了解相关领域的重要进展。会议发言全部采用英文。为使读者更清晰地了解发言内容,我们对部分讲座由主讲人提供了中文摘要,现同时发表,以飨读者。     

先天性心脏和大血管畸形的电子束计算机断层摄影术诊断--与超声心动图的对照研究

目的:探讨电子束计算机断层摄影术(EBT)和超声心动图在先天性心脏和大血管畸形诊断中的价值. 方法:收集34例分别经超声心动图和EBT检查的心脏和大血管畸形诊断资料,其中18例经心血管造影检查证实,21例有手术结果对照.结果:EBT诊断符合率82.4%,超声心动图诊断符合率73.5%.EBT对心外大血管畸形诊断准确率为97.9%,明显优于超声心动图(53.2%).而超声心动图对心内畸形的诊断准确率为95.9%,高于EBT(81.6%).对大血管与心室、房室连接处的畸形二者的诊断准确率基本相同.结论:超声心动图与EBT检查相结合,可明显提高先天性心脏病的诊断准确率,减少有创的心血管造影检查.     

Sepsis in Premature Newborns with Congenital Heart Disease

Objective. To determine the incidence and distribution of neonatal sepsis in premature newborns with congenital heart disease (CHD) according to gestational and postnatal age, time of onset, and type and frequency of causing agents, and compare it with premature newborns without CHD. Design, Setting, Patients. A clinical investigation on 80 premature newborns admitted to neonatal intensive care unit (NICU) of Pediatric Clinic University Medical Center Sarajevo, Bosnia and Herzegovina, between October 23, 2007 and March 18, 2009. We analyzed the incidence and distribution of neonatal sepsis in premature newborns with CHD according to gestational and postnatal age, time of onset, and type and frequency of causing agents, and compared it with premature NICU patients without CHD. Results. Of the 80 premature newborns included in our study, 14 had CHD with patent ductus arteriosus as the most common type of anomaly. Culture-proven sepsis was diagnosed in 28.57% premature newborns with CHD and 12.12% premature newborns without CHD. The three most common causing agents were Staphylococcus aureus, Klebsiella species, and Serratia species. Conclusion. Premature newborns with CHD have a higher risk of acquiring sepsis during hospitalization in NICU, probably because of longer duration of hospitalization and need for invasive procedures such as mechanical ventilation, central venous catheters, and parenteral nutrition.     

Echocardiographic Assessment of Conjoined Twins with Congenital Heart Disease in Shanghai

Background: The aim of this study is to improve the diagnosis of congenital heart disease in conjoined twins using echocardiography. Methods: Six sets of conjoined twins at Shanghai Children's Medical Center and Xin-Hua Hospital from 1980 to 2006 were assessed retrospectively. Cardiac anomalies of varying degrees of severity were first evaluated using 2D echocardiography. Tissue Doppler imaging (TDI) was then performed if fused ventricles were suspected. Peak systolic velocities, peak systolic strain rates, and peak systolic strains at the fused myocardium were quantitatively measured using strain rate imaging (SRI). If the M-mode echocardiographic image was poor or difficult to measure, the myocardial performance index (MPI) of the left ventricle was calculated. Results: Intracardiac anomalies were diagnosed correctly using echocardiography and confirmed by surgical findings. Cardiac functional assessment using MPI demonstrated heart failure in three out of the eight individuals. Subtle conjunction of the ventricles, however, were more difficult to visualize and two sets of conjoined twins with fused hearts could not be clearly demonstrated by echocardiography. In one case of suspected ventricular wall conjunction, TDI showed separate ventricular myocardia which was confirmed at surgery. Conclusions: Intracardiac anomalies and ventricular function can be readily demonstrated by echocardiography, but subtle conjunction of the ventricles may be more difficult to visualize. TDI may be required if there is uncertainty about the degree of cardiac fusion.     

电子束计算机断层摄影术在小儿复杂先天性心脏病诊断中的应用

目的 :评价电子束计算机断层摄影术 (EBCT)在小儿复杂先天性心脏病 (先心病 )诊断中的价值。　　方法 :对 2 6例患者经胸常规超声心动图 (TTE)诊断为复杂先心病 ,同时做 EBCT增强单层容积扫描 ,并由计算机工作站进行图像三维重建。其中 9例又做了常规心血管造影 ,11例经外科手术 ,进行对照研究。　　结果 :全组 11种复杂先心病共 6 1处畸形 ,其中心内畸形 2 1处 ,EBCT与 TTE均作出正确诊断。然而 ,心外大血管畸形及心室—大血管连接异常诊断中两者有明显差别 ,在 40处畸形中 ,EBCT过多诊断 1处 (动脉导管未闭 ) ,手术证实为假阳性 ,EBCT诊断符合率为 97.5 % (39/ 40 ) ;TTE诊断 35处 (误诊 1处 ,漏诊 4处 ) ,TTE诊断符合率 87.5 % (35 / 40 )。EBCT与TTE诊断的正确率有显著差异 (χ2 =3.936 ,P<0 .0 5 )。TTE与 EBCT相结合使诊断的总准确率提高到 98.4% (6 0 / 6 1)。　　结论 :EBCT对复杂先心病中某些畸形的检出优于 TTE。EBCT血管造影与 TTE及心血管造影相结合 ,可提高对复杂先心病诊断的准确率 ,以指导手术。     

双源计算机体层成像对复杂型先天性心脏病的诊断价值

评价双源计算机体层成像对复杂型先天性心脏病的诊断价值。分别从双源计算机体层成像自身的机械优势、检查心脏疾病扫描速度快、图像清晰,后处理技术多样等方面进行阐述,总结双源计算机体层成像在诊断心脏疾病方面的优势。双源计算机体层成像是评价复杂型先天性心脏病的快捷而有效的影像学技术,具有检查方便、迅速、无创伤、诊断准确率高等优点。     

Echocardiographic Assessment of Ventricular Synchrony in Congenital and Acquired Heart Disease in Children

Electromechanical dyssynchrony is an important consequence of and contributor to ventricular dysfunction. Echocardiography can be useful to assess the mechanisms underlying mechanical dyssynchrony, to evaluate the impact of mechanical dyssynchrony on ventricular function, and to try to predict the therapeutic response to cardiac resynchronization therapy (CRT). Mechanical dyssynchrony has been demonstrated in several pediatric acquired and congenital cardiac conditions, but experience is still limited. Moreover, the optimal method to identify dyssynchrony remains unclear, and data predicting the response to CRT in pediatrics are lacking. Understanding mechanisms of electromechanical dyssynchrony by echocardiography seems promising, at least in left bundle branch block (LBBB), but may be limited in children due to the uncommon occurrence of LBBB in this population. This review addresses the commonly used methods to diagnose mechanical dyssynchrony, discusses the emerging concepts on the mechanisms of the various types of mechanical dyssynchrony, and discusses the possible significance of mechanical synchrony in pediatric and acquired congenital heart disease.     

胎儿先天性心脏病的超声诊断及漏诊分析

目的探讨超声诊断胎儿先天性心脏病的可行性和临床价值。方法采用彩色多普勒超声对6000例孕20~40周的孕妇常规行胎儿四腔心,左、右室流出道,主动脉弓及动脉导管的观察。结果发现心脏畸形24例;经尸检及出生后心超证实。合关心外畸形7例。漏诊9例。结论超声诊断胎儿先天性心脏病是可行的,值得推广。