经胸超声心动图在继发孔型房间隔缺损介入治疗中的作用

目的研究经胸超声心动图(TTE)在继发孔型房间隔缺损(ASD)介入治疗的病例筛选及封堵器选择方面的应用价值。方法回顾分析2002-03—2006-03于山东大学山东省立医院小儿心脏科行介入治疗的54例继发孔型ASD患儿，统计其术前TTE所测的ASD的形态、大小、边缘情况等，对术前TTE测得的ASD最大径、X线测得的球囊腰径及TTE测得的球囊径分别与所用封堵器型号大小进行统计学分析比较，并进行TTE测得的ASD最大径与封堵器型号大小的相关性分析，计算回归方程。结果54例均成功封堵，手术时间20~145(57.64±24.89)min，曝光时间3.1~31.5(9.22±7.41)min，住院天数3~10(5.74±1.72)d。其中有15例患儿存在ASD单一边缘不够标准，均封堵成功。术前TTE测得的ASD最大径［4~33mm,(16.31±7.34)mm］、术中X线测球囊腰径［6.7~28mm,(19.80±7.24)mm］及TTE测球囊径［9.6~24.8mm,(19.92±6.38)mm］与封堵器大小［5~36mm,(18.85±7.89)mm］差异均无显著性意义(P>0.05)。且术前TTE测得的ASD最大径与封堵器型号有良好的线性相关(r=0.945，P<0.05)，计算回归方程为：封堵器型号=1.015×(TTE测得的ASD最大径)+2.3mm。结论TTE的应用，使ASD介入治疗病例的筛选得到了保证。作为一种无创性影像学诊断方法，对ASD封堵器选择的评估有重要的应用价值。

Effect of transthoracic echocardiography in transcatheter closure of secundum atrial septal defect.

AbstractObjectiveTo study the values of transthoracic echocardiography (TTE) in the choice of cases and occluders in transcatheter closure of secundum atrial septal defect (ASD).MethodsRetrospective study was done on 54 secundum ASD children who underwent interventional therapy in our hospital from March 2002 to March 2006.TTE was done on performed to examine the shape、size、rims of ASD.Statistically compare the occluder size with the largest diameter of ASD measured by TTE、the balloon-stretched diameter measured by X-ray and by TTE respectively.Dependablity analysis and regression equation were done between the occluder size and the largest diameter of ASD measured by TTE.ResultsFifty-four cases were successfully performed.The procedure time was 20~145(57.64±24.89)min，the fluoroscopy time was 3.1~31.5(9.22±7.41)min，hospital stay was 3~10(5.74±1.72)days.Fifteen patients had only one deficient rim，who all performed successfully.There was no significant difference (P>0.05) between the largest diameter of ASD measured by TTE(4~33mm，16.31±7.34mm)、the balloon-stretched diameter measured by X-ray(6.7~28mm，19.80±7.24mm)、by TTE(9.6~24.8mm，19.92±6.38mm) and the occluder size(5~36mm，18.85±7.89mm).And there was good linear correlation(r=0.945，P<0.05)between the largest diameter of ASD measured by TTE and the occluder size，their regression equation was: the occluder size =1.015×(the largest diameter measured by TTE)+2.3mm.ConclusionTTE is a good measurement to choose cases in ASD intervention，and as a no-injury imageology diagnostic method，it has important values to evaluate the choice of ASD occluders.