脊柱包虫病的诊断与治疗

目的:探讨脊柱包虫病的诊断及治疗方法。方法:1990年10月～2010年10月手术治疗脊柱包虫病患者9例,病程为3个月～12年。临床表现为午后低热、腰背疼痛和腰背部包块,术前脊髓神经功能Frankel分级A级1例,B级2例,C级2例,D级4例。包虫病8项免疫试验均为阳性。术前均行影像学检查,病变单纯累及胸椎2例(T8、T9 1例,T11、T12 1例),腰椎2例(L3 1例,L1、L2、L3 1例),胸腰段4例(T12、L1 2例,T12、L1、L2 2例),骶椎1例。X线片、CT检查误诊为椎体结核5例、转移瘤2例、脊索瘤1例、腰大肌脓肿1例。MRI检查7例诊断为脊柱包虫病;2例病变单纯累及腰椎者缺乏囊中囊典型信号改变,误诊为脊柱转移瘤。均行椎管减压病灶清除植骨内固定术,其中病变单纯累及胸椎的2例与骶骨1例行后路全椎板切除减压,2例腰椎病变者行椎板间开窗椎管减压,4例胸腰段病变者行脊柱侧前方入路经横突椎管减压。7例术前诊断脊柱包虫病者术前口服抗包虫药阿苯达唑2～3周,所有患者术后继续服用阿苯达唑3个月。结果:手术时间210～330min,平均260min;术中失血量170～470ml,平均300ml。7例术前MRI检查诊断为脊柱包虫病者术后病理诊断为脊柱细粒棘球蚴病,2例术前MRI误诊为脊柱转移瘤者术后病理诊断为腰椎泡状棘球蚴病。随访1～10年,平均4.6年。1例腰椎泡状棘球蚴病患者术后8个月植骨未愈合,经理疗、促骨生长药物治疗,1年后复查X线片显示骨性愈合;其余8例患者植骨区骨性融合,愈合时间为5～8.5个月,平均7个月。末次随访患者脊髓神经功能Frankel分级改善6例,无变化3例。随访期间无复发。结论:MRI检查对脊柱细粒棘球蚴病有诊断价值,对腰椎泡状棘球蚴病易误诊,后者的确诊有赖于病理检查;脊柱包虫病在药物治疗的基础上采用手术治疗可取得较好疗效。     

非典型CE1型肝囊型包虫病的诊断及腹腔镜治疗体会

目的:探讨非典型CE1型肝囊型包虫病的有效诊断方法及腹腔镜手术的临床疗效。方法:回顾性分析2018年6月至2019年6月新疆维吾尔自治区人民医院收治的17例非典型CE1型肝囊型包虫患者临床资料,其中男性11例,女性6例,年龄(46.0±21.6)岁,均有畜牧区接触史。术前完善包虫免疫实验、腹部超声、腹部CT检查,行腹腔...     

Neuroendoscopic septostomy for isolated lateral ventricle

The clinical features and endoscopic findings were investigated in 20 patients with isolated lateral ventricle treated by neuroendoscopic septostomy to establish cerebrospinal fluid communication and open an isolated ventricular compartment. The endoscopic procedure was incomplete because of thickened septum pellucidum and insufficient working space in two adults with postmeningitic hydrocephalus. Two children underwent second septostomy. In all other cases, results were good and there were no complications related to endoscopic procedures. Endoscopic septostomy is less invasive and has few complications. Intraoperative navigation and the biportal approach may be required in difficult cases with multiple septum formation and severe postmeningitic hydrocephalus. Adequate stomal size is required in high-risk groups including children under 2 years of age.     

Exclusion of the non-functioning right ventricle in children with pulmonary atresia and intact ventricular septum

OBJECTIVE: A group of patients with pulmonary atresia and intact ventricular septum (PAIVS) have to undergo single ventricle repair. In these patients, the presence of the non-functioning right ventricle (RV) may lead to the aggravation of RV to coronary connections and left ventricular (LV) dysfunction. To prevent these deleterious effects, the RV was excluded surgically. METHODS: Between December 2000 and February 2006, 10 patients with PAIVS underwent RV exclusion in conjunction with cavo-pulmonary anastomosis (n=6) or systemic-to-pulmonary artery shunt (n=4). Median age at surgery was 5 months (range, 0.2-13.8). Median z-value of the tricuspid valve was -4.0 (range, -6.5 to -1.3). None had RV dependent coronary circulation. The tricuspid valve was closed directly or using a patch. Thrombotic materials were inserted into the RV cavity in eight patients. RESULTS: There was no mortality. Follow-up was completed in all patients for up to 79.1 months (median, 30.3). Seven patients underwent a Fontan procedure and the other three are waiting. Eight patients showed completely obliterated RV after exclusion. One of the two patients who had residual RV cavity underwent re-exclusion after a Fontan operation. Postoperative echocardiography revealed that LV end-diastolic dimension increased with borderline significance (p=0.050), whereas LV end-systolic dimension showed no significant changes. During follow-up, LV showed no evidence of regional ischemia or global dysfunction, and fractional shortening significantly increased compared with the pre-exclusion value (p=0.017). CONCLUSIONS: This study demonstrates that RV exclusion may be performed safely in a selected group of patients with PAIVS. This procedure may have beneficial effects on LV systolic function, by preventing possible ischemia, and on LV diastolic function, by obliterating the non-functioning cavity and improving the geometry of the ventricular septum.     

Tricuspid atresia versus other complex lesions. Comparison of results with a modified Fontan procedure

Several modifications of the Fontan principle are currently applied to the treatment of tricuspid atresia with low mortality. The use of these modifications in other malformations has most frequently been associated with less satisfactory results. At our institution, from June 1977 to October 1986, 35 consecutive patients, whose ages ranged from 8 months to 20 years (median age 3.4 years), underwent a modified Fontan procedure. Twenty patients with a median age of 3.2 years (group I) having tricuspid atresia (16 patients) or hypoplastic right heart syndrome (four patients) were treated by means of a right atrium-pulmonary artery anastomosis (12 patients) or right atrium-subpulmonary chamber connection (eight patients). Fifteen patients (group II) with a median age of 3.6 years, having a single left ventricle (10 patients), left atrioventricular valve hypoplasia or atresia (three patients), or double-outlet right ventricle (two patients), underwent right atrium-pulmonary artery anastomosis, together with a repositioning of the atrial septum to the right of the right atrioventricular valve, which thus left intact the inlet to the ventricle(s). The operative mortality rate was 25% in group I and 0% in group II. One patient in group I and one in group II died late postoperatively. All the 28 survivors are free of symptoms 3 months to 9 years after correction. According to our results, low risk can be associated with modified Fontan procedures in the treatment of complex heart malformations other than tricuspid or pulmonary atresia. Preserving the integrity of the entire inlet to the ventricle(s) by repositioning the interatrial septum, as done in group II malformations, might be helpful in improving the quality of the repair.     

Postinfarction ventricular septal defect. An efficacious technique for early surgical repair

Between December 1982 and June 1987, seven consecutive patients (52 to 77 years old) underwent early surgical repair of postinfarction ventricular septal defect. The defect was diagnosed 3 to 10 days after the myocardial infarction. A new repair technique was used which stresses that no part of the infarcted septum be resected. This technique consists of a transinfarction incision in the left ventricle, placement of a fine Dacron fabric patch that covers all the infarcted septum and closes the ventricular septal defect, and placement of a second Dacron fabric patch that reinforces the infarcted anterior wall of the heart and supports the buttressed double suture closure of the left ventriculotomy. One very ill patient of this series died during the operation (mortality rate 14.3%). Three patients required the help of intraaortic balloon counterpulsation postoperatively, and five needed inotropic drug support. None of the patients had excessive bleeding. Two initial patients had a small left-to-right interventricular shunt. Postoperative angiographic studies and Doppler echocardiography confirmed the existence of a nonsignificant residual ventricular septal defect in these two patients and showed good geometry of the left ventricle with no aneurysm formation in all six survivors. This technique seems to be efficacious. It can be expeditiously performed, and the risks of postoperative complications related to the technique appear to be minimal.     

Surgical management of congenitally corrected transposition of the great arteries]

From 1962 to 1990, we have experienced 12 patients with congenitally corrected transposition of the great arteries (CTGA). Associated cardiac defects were present in all cases, most frequently ventricular septal defect (100%), and pulmonary stenosis (67%), Palliative procedures were done in 5, corrective operations in 6. One patient underwent corrective procedure 27 years after palliation. The hospital mortality rate was 8% (1/12), and 1 late death (8%) was seen in this series. In most cases, we approached the defect through the mitral valve, and the deLeval method was very useful in placing stitches along the trabecular septum. AV conduction disturbance could be avoided in 5 of 6 patients who underwent the closure of ventricular septal defect. Pulmonary stenosis was relieved by valvotomy and/or infundibulectomy, or implantation of an extracardiac conduit according to their anatomy. Cardiac function of systemic ventricle (morphologic right ventricle) were well preserved in the case undergoing intracardiac repair and also in the palliative cases. Careful observation is needed in these cases.     

婴幼儿室间隔完整的重度肺动脉瓣狭窄手术方案探讨

目的　探讨婴幼儿室间隔完整的重度肺动脉瓣狭窄 (PS)的手术指征和手术方法。方法　1999年 6月至 2 0 0 4年 3月 ,手术治疗室间隔完整的重度PS婴幼儿 2 8例 ,年龄 1 3～ 2 9 0个月 ,平均( 11 3± 2 0 )个月。体重 3 5～ 12 5kg ,平均 ( 8 5± 1 2 )kg。据不同的手术方法分 3组 ,第 1组 18例 ,三尖瓣Z值 - 1 0～ - 1 6 ,11例经肺动脉切口行肺动脉瓣膜交界切开 ,7例因瓣环小而采用自体心包补片进行右心室流出道至肺动脉的补片扩大 ;9例因术后低氧血症而加作体肺分流术。第 2组 7例 ,Z值- 1 5～ - 4 8,行 1 心室修补 ,即右心室流出道至肺动脉的补片扩大 上腔静脉与右肺动脉的腔肺血管吻合 (BDG) ;第 3组 3例 ,Z值 - 4 5～ - 6 7,行肺总动脉横断同时行BDG。结果　手术死亡 1例。余2 7例生存 ,术后血流动力学稳定 ,经皮氧饱和度平均 0 95。随访 3～ 2 4个月疗效满意。结论　术前判断右心室发育不良的程度是手术成功的关键 ,手术方式除选择单心室和双心室修补外 ,1 心室修补手术是一种安全、可靠、有效的手术方法     

Surgical treatment of dissecting aneurysm of the interventricular septum.

OBJECTIVE: We reviewed our experience in the surgical treatment of an extremely rare disease, dissecting aneurysm of the interventricular septum (DAIS). The definition of DAIS is that the interventricular septum is dissected and forms an aneurysm which bulges into both the left and right ventricles, causing obstruction of both ventricular outflow tracts. It communicates with the aortic root, and may communicate with the ventricle. It is usually associated with aortic valve regurgitation and aortic annular enlargement. DAIS might also be related to the sinus of Valsalva aneurysm [Ann Thorac Surg 65 (1998) 735; Ann Thorac Surg 51 (1991) 996; Eur J Thorac Surg 12 (1997) 759]. But in three of our six patients DAIS was not associated with sinus of Valsalva enlargement or aneurysm. METHODS: Between May 1992 and November 2000, six of 30,701 patients were diagnosed with DAIS, and underwent surgery at Fu Wai Hospital in Beijing. Aortic valve replacement was performed in five patients, and the perforation at the bottom of the right sinus of Valsalva was repaired in one. The aneurysm was resected simultaneously in all these patients. RESULTS: One of the six patients required re-operation. And all patients recovered uneventfully without hospital mortality. CONCLUSIONS: DAIS has a progressive course and poor prognosis. Early diagnosis and surgical treatment are mandatory.     

Endoscopic treatment of para- and intraventricular cerebrospinal fluid cysts.

This study has been made to define the role of endoscopy and the most appropriate approach and technique of endoscopic fenestration of paraventricular and intraventricular CSF cysts according to the cyst size and location. Twenty-two patients with intraventricular (13 cases) and paraventricular (9 cases) CSF cysts, operated upon by endoscopic technique in three Italian neurosurgical centers, are reviewed. Paraventricular hemispheric cysts have been treated by endoscopic fenestration from the cyst to the lateral ventricle. Midline intraventricular cysts (2 of the septum pellucidum and 4 of the velum interpositum) underwent fenestration from the right lateral ventricle to the cyst, with fenestration in both lateral ventricles in one case. Cysts of the choroid plexus have been fenestrated from the homolateral enlarged ventricle (4 cases) or from the contralateral compressed ventricle (2 cases). Twenty patients (more than 90%) were definitively cured by the endoscopic procedure, whereas only 2 patients required a shunt or a direct approach. We think that the endoscopic fenestration must be considered the treatment of choice of intraventricular and paraventricular CSF cysts.     

Costal hydatidosis: management and outcome of five cases

The objective of the study was to report our experience in the management of hydatid cyst of the rib. Between December 2001 and December 2009, five patients underwent surgery for costal echinococcosis, among 234 cases of thoracic hydatid cyst managed in our department. They were three males and two females, aged 19-42 years (mean = 32.2 years). Imaging investigations consisted of chest X-ray and computed tomography. All the patients underwent thoracotomy along the arch of the infected rib. Albendazole was administered postoperatively in all cases. The echinococcosis of the rib was primary in 3 cases, and secondary to thoracic localization in 2 cases. It was located on the right side in four patients, on the left one in one patient. The posterior arch was the site of infection in 3 cases, and the anterior arch in 2 cases. The cyst was intact in 4 cases, and the invasion of adjacent structures was found in one case. There were no concomitant hydatid lesions. The resection of the infected rib was total in 2 cases and partial in 3 cases. There was no postoperative mortality or complications. The follow-up ranged from 28 months to 8 years did not show any recurrence. Echinococcosis of the rib is very rare. To avoid complications and to allow the eradication of the disease, the combination of surgery and antihelmentic drugs remains the best therapeutic choice.     

Hepatic echinococcosis and its surgical treatment

973 patients were operated for the period of 14 years for echinococcosis of the abdominal cavity. Echinococcosis of the liver was revealed in 742 (76.2%) patients. Complicated forms of echinococcosis were registered in 42.3% patients. Suppurative cyst was detected in 138 (43.9%) patients; perforation of the cyst into free abdominal cavity--in 22 (7%), into pleural cavity--in 14 (4.5%) patients, into bile ducts--in 62 cases (19.7%); biliary tracts compressing by the cyst with mechanical jaundice--in 29 (9.2%) patients; bilio-pulmonary bronchial fistula was revealed in 7 (2.3%) patients and calcification of the cysts--in 42 (13.4%). Radioisotope scanning, X-ray, ultrasound, Computed tomography and serological reactions were used for diagnosis. For differential diagnosis of parasitic cysts from non-parasitic cysts laparoscopic video technique was also used in three cases. Radical operations were carried out in 47 patients, 19 patients from them underwent total pericystectomy and 28 patients underwent resection of the liver. For echinococcosis of the liver complicated by mechanical jaundice: in this case echinococcectomia was done with the correction of the continuity of the bile duct. Ultrasound cavitation, CO2 laser, thermal or thermic means (70 degrees C solution of furaciline or instant steam treatment) were used for antiparasitic purposes.     

Unusual Recurrence of Hydatid Cysts of the Heart: Report of Two Cases and Review of the Clinical and Surgical Aspects of the Disease

In cardiac echinococcosis, a hydatid cyst most frequently forms either solely in the heart or in the pericardium, but there are several reports of cysts forming in the liver or lung or in both. In two cases reported here, both patients developed cysts in new sites after one or more previous surgeries for hydatid cyst removal. In Case 1, the patient first underwent spleenectomy and resection of multiple cysts with no evidence of a cyst in the heart; 3 years later, there was no sign of Echinococcus in the liver, but a large inframyocardial cyst had damaged the left ventricle. In Case 2, the patient first underwent surgery to remove cysts from the pericardium, 2 years later from the anterior wall of the left ventricle, and, finally, 8 months after this second operation, from the left atrium also with no evidence of cyst formation anywhere else in the heart at the time of surgery. These cases emphasize the need for thorough and frequent reevaluation to detect new hydatid cyst formation in the heart and elsewhere caused by the Echinococcus organism.     

Endoscopic fenestration of symptomatic septum pellucidum cysts: three case reports with discussion on the approaches and technique.

OBJECTIVES: We describe three patients with symptomatic septum pellucidum cysts treated by endoscopic fenestration and discuss the different endoscopic approaches to these cysts. CLINICAL PRESENTATION: The patients are an 8-year-old boy, a 7-year-old boy and a 21-year-old woman; this last also had a right frontal cavernous angioma and a pituitary microadenoma. All patients presented with headache, associated with vomiting in two and behavioral changes in one. In all cases magnetic resonance showed a septum pellucidum cyst. INTERVENTION: Two patients were operated upon by posterior approach through a right occipital burr hole and underwent fenestration from the right occipital horn to the cyst, with a second fenestration from the cyst to the left lateral ventricle in one. Another patient underwent microsurgical removal of a right frontal cavernoma and endoscopic cyst fenestration with both lateral ventricles through a right frontal craniotomy. Postoperatively, headache and vomiting resolved in all cases and behaviour changes improved in one. CONCLUSIONS: Endoscopic fenestration is the treatment of choice for septum pellucidum cysts, where it results in immediate relief of the mass effect of the cyst and in the remission of the associated symptoms. We suggest a posterior approach through a right occipital burr hole. It allows one to easily cannulate the occipital horn, which is usually larger than the frontal one, thus avoiding the risk of damaging the vascular and neural structures surrounding the foramen of Monro. Besides, the endoscopic trajectory is in our opinion more direct. The two-window technique, with fenestration of the cyst into both lateral ventricles, improves the chances of long-term patency.     

Thyroid cancer in children: Report of three cases and a review of the Japanese literature

We experienced three cases of thyroid cancer in children less than 15 years of age between 1982 and 1995. We herein present these three cases with a review of 141 reported cases of childhood thyroid cancer in Japan. Our patients were 6, 13, and 14 years old. The patients, all girls, were diagnosed as having thyroid cancer based on diagnostic imaging. One of them was also diagnosed by a fine-needle aspiration biopsy (FNAB). One of them underwent subtotal thyroidectomy, and the other two underwent lobectomy. Modified neck dissections were performed on all three. Pathologically, the tumors were all papillary carcinomas. Multiple lymph node metastases were present in all patients. However, the postoperative courses have been good, and there have been no signs of recurrence, 10, 8, and 2 years after their respective operations. In 144 reported cases of childhood thyroid cancer in Japan including ours, the youngest patient was a 2-year-old boy, and the female to male ratio was 2.1:1. FNAB was performed in 25 cases, and 23 (92%) of the tumors were diagnosed as malignant. Histologically, 76% were papillary carcinoma and 20% follicular carcinoma. At operation, lymph node metastases were found in 80% of the cases and lung metastases in 17%. For treatment, 88% of the patients received a more extensive operation than a lobectomy. Of the 144 patients, 8 died.     

解剖性肝切除治疗肝泡型包虫病临床价值研究

目的 探讨解剖性肝切除手术对肝泡型肝包虫病肝切除病人的临床应用价值。方法 回顾性分析2017年1月至2018年12月青海省人民医院行肝切除手术治疗的62例肝泡型包虫病病人的临床资料,按肝切除手术方法分为解剖性肝切除组（35例）和非解剖性肝切除组（27例）,分别比较两组病人术前基本资料、术中情况及术后临床指标。结果 两组病人在年龄、性别、包虫数量、包虫大小及术前肝功能指标差异均无统计学意义（P＞0.05）;而术中出血量、输血量、术后肝功能指标［天冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）、总胆红素（TBIL）和直接胆红素（DBIL）］、并发症发生率及术后住院时间差异有统计学意义（P＜0.05）。结论 解剖性肝切除技术同样适用于肝泡型包虫病病人的外科治疗,而且具有肝功能损伤小、并发症发生率低及术后住院时间短等优势。     

Operative treatment of alveolar echinococcosis of the liver

This study is based on the experience with 51 cases of hepatic alveolar echinococcosis underwent operative treatment up to the end of 1976. Hepatic resection was carried out in 28 cases with overall operative mortality of 25 per cent, but no death occurred in the last 10 years period during which 12 cases were subjected to the procedure. This apparent improvement of the result is ascribed to the establishment of the strict criteria for operative intervention, i.e., when less than three segments are involved, the hepatic hilum is not highly involved, and the inferior vena cava is not invaded. Marsupialization is employed when hepatic resection is not indicated and the lesion shows liquefaction. Ten cases underwent the procedure with one operative death. Biliary tract reconstruction was carried out in two cases with hilar involvement, but the prognosis was poor. Eleven cases were only with celiotomy. The follow-up studies indicated that the hepatic resection offers the best hope for cure followed by marsupialization. Unlike unilocular echinococcosis in which a cyst grows expansively, the alveolar echinococcosis should be considered clinically malignant, in that it grows invasively and often shows metastatic lesions. Surgical intervention at its early developmental stage is the only definitive way of the treatment. Only recent advances in diagnostic procedures and development of type specific serological studies made it possible to bring the disease under control.     

Surgical Approach to the Management of Cardiovascular Echinococcosis

Abstract   Objective: Echinococcosis is a serious health problem in some regions of the world. Although cardiovascular hydatid cyst is rare, its early diagnosis and surgical management is important. Methods: We reviewed 10 patients with cardiovascular hydatid cyst who underwent surgery in our department between January 1982 and 2007. Standard cardiopulmonary bypass and antegrade cardioplegia with aortic cross-clamping were used in all but one patient. After the cysts were removed, the cavity was cleaned and then obliterated with purse-string sutures. Albendazole was used in all patients. The mean follow-up was 4.5 years. Results: The mean age was 27 years (range 12 to 76 years). Eight patients were men. The hydatid cysts were located on left ventricle (five patients), left atrium (two patients), right ventricle (three patients), right atrium (one patient), pericardium (one patient), and aorta (one patient). Except for two patients who died, all were discharged without postoperative complications. There was no late cardiac mortality or recurrence. Conclusions: Cardiac hydatid cyst should be treated surgically without delay. Although its surgical treatment carries a high complication rate, gentle handling of the heart during cardiopulmonary bypass minimizes operative risk.     

Left atrial myxomas: clinical characteristics, evaluation and considerations in classifying tumors]

Eleven patients underwent surgical excision for left atrial myxomas. Clinical symptoms, coronary angiographic findings and operative procedures were evaluated. Myxomas were classified into two types based on macroscopical findings, and clinical characteristics of these two types were analyzed. Seven cases (64%) classified as "lobular-type myxomas" were seen as lobulated, gelatinous and fragile. Four cases (36%) were classified as "round-type myxomas" were round and elastic soft. Primary symptoms included dyspnea on exertion in five cases (45%) and neurological disturbances in six cases (55%). Brain emboli were found in four patients by CT scan, and were classified as lobular-type myxomas. These eleven myxomas successfully removed in all cases. Four of these myxomas, which were pedunculated with fine fibrous stalks, were shaved along the base at the atrial septum or free wall. Others were excised completely along with a portion of the adjacent septum. Microscopic examination of the operative specimens revealed that two lobular-type myxomas with broad-based attachment to left atrial septum had invaded the atrial septum. All patients are doing well and have had no signs of myxoma recurrence at postoperative periods ranging from 10 months to 12 years (mean follow-up 5.3 years). Seven patients underwent selective coronary angiography due to a diagnosis of a coronary artery disease. All coronary angiograms were normal in all cases. In five (71%) of these seven, abnormally dilated atrial branches were seen as supplying the tumor. In two cases with round-type myxomas, neovascularity was evident and was made up of clusters of tortuous vessels with tumor blush.(ABSTRACT TRUNCATED AT 250 WORDS)     

超声三维斑点追踪成像评价肥厚型心肌病左心室扭转运动

目的应用超声三维斑点追踪成像(3D-STI)技术评价肥厚型心肌病(HCM)左心室扭转运动特征。方法收集非梗阻性HCM患者28例(HCM组)及正常志愿者25名(对照组),应用3D-STI获取并定量比较其左心室收缩及舒张末期容积、射血分数、质量和室壁基底水平及心尖水平收缩期旋转角峰值、局部扭矩峰值,左心室整体及局部收缩期扭转角峰值、左心室整体收缩期扭矩峰值等参数。结果 HCM组左心室收缩及舒张末期容积减小,左心室质量增加,左心室壁基底水平收缩期旋转角峰值和局部扭矩峰值、左心室整体收缩期扭转角峰值和扭矩峰值以及室间隔基底水平和心尖水平局部扭转角峰值均大于对照组(P均<0.05),而左心室射血分数、心尖水平收缩期旋转角峰值和局部扭矩峰值差异均无统计学意义(P均>0.05)。结论HCM患者左心室整体及部分节段(室间隔基底水平和心尖水平)收缩期扭转运动能力较正常人增强。左心室整体收缩期扭转角峰值能更好地反映HCM的异常心肌力学状态。