实时三维超声心动图评价室间隔缺损患者手术前后左室功能的研究

目的：应用实时三维超声心动图（Real—time three—dimensional echocardiography，RT-3DE）探讨外科修补手术与内科介入封堵手术对先天性心脏病室间隔缺损（CHD-VSD）患者左室功能的影响，并探讨RT-3DE评价左室功能变化的准确性。方法：65例CHD-VSD患者分为内科介入封堵组30例和外科修补组35例，正常组30例为健康志愿者，应用RT-3DE及M型超声心动图分别测量CHD-VSD患者及正常组的左室心功能参数，并对测量参数进行统计分析。结果：术前两组CHD-VSD患者各参数均增大，术后左室心功能参数除左室射血分数外，余参数均相应减小，差异有统计学意义（均P〈0．05），并且RT-3DE测量左室容积与M型超声相关性良好，但前者较后者测值稍偏小。结论：CHD-VSD患者术前容积增大，左室功能稍降低，术后内科介入封堵组各参数值接近正常值，而外科修补组虽较术前改善，仍稍降低；RT-3DE可准确测量左室容积及心功能，为临床诊疗方案提供依据。

ASSESSMENTON OF LEFT VENTRICULAR FUNCTION IN PATIENTS WITH VENTRICU- LAR SEPTAL DEFECT BEFORE AND AFTER SURGERY USING REAL-TIME THREE DI- MENSIONAL ECHOCARDIOGRAPHY

Objective：To evaluate left ventricular function before and after operation in ventricular sepal de- fect （VSD） patients using real-time three-dimensional echocardiography （RT-3DE）, and assess the veracity of left ventricular function by RT-3DE. Methods： Sixty-five patients with VSD and 30 healthy volunteers were involved, RT-3DE and M-mode echocardiography were used to measure the left ventricular function parameters, and the results were analyzed statistically. Results： All preoperative parameters increase in two groups of patients with VSD. The postoperative left ventricular function parameters in patients with VSD were correspondingly reduced （ P 〈0.05 for all） except ejection fraction. RT-3DE had a good correla- tion with M-mode echocardiography in measurements of left ventricular volume, but the former is smaller than the later one. Conclusion： Preoperative volume increased in patients with VSD, and left ventricular function slightly reduced, the parameters in intervention group are close to normal. Although the parame- ters in surgical repair group were also improved as compared with those before operation, they were still slightly low. RT-3DE can accurately measure left ventricular volume and cardiac function, and provide the basis for clinical treatment programs.