超声心动图对儿童完全性肺静脉异位引流诊断价值的探讨

目的　旨在评价超声心动图对完全性肺静脉异位引流 (TAPVD)的诊断价值。方法　对 1987年 9月至2 0 0 2年 11月收治的TAPVD患儿 70例进行分析。均有完整的临床及超声心动图资料 ,其中 35例施行了手术治疗。结果　 70例TAPVD的解剖分型为 :心内型 5 2例、心上型 16例、心下型 2例 ,未发现混合型。 35例施行手术 ,32例与术前超声心动图的诊断一致 ;3例与超声心动图诊断不完全一致 ,其超声心动图诊断分别为 :三房心伴继发孔房缺、左房隔膜伴继发孔房缺、原发孔房缺伴卵圆孔未闭 ,而手术结果均显示为心内型TAPVD伴继发孔房缺。结论　超声心动图检查是诊断TAPVD重要且准确的方法 ,并能确定其分型 ,提供精确的解剖及血流动力学资料。在应用超声心动图诊断TAPVD时 ,应注意与三房心、左房隔膜等疾病进行鉴别。

Diagnosis of total anomalous pulmonary venous drainage by using color Doppler echocardiography

Objective To evaluate color Doppler echocardiography in diagnosing total anomalous pulmonary venous drainage(TAPVD).Methods Of 70cases of TAPVD hospitalized from September 1987 to November 2002,35 underwent surgical repair.Results There were 52 intracardiac,16 supracardiac and 2 infradiaphragmatic types in the 70 cases of TAPVD.No mixed type was found in this group.The diagnosis of 32 cases made by echocardiography were absolutely in accordance with the results of operation;3 cases were misdiagnosed as Cor triatriatum,membrane of left atrium and primary ASD defect with PFO by echocardiography,but further result of surgery showed they were intracardiac type of TAPVD.Conclusion The echocardiographic diagnosis of TAPVD is important and accurate. It can also differentiate all the types of this disease,but the echocardiographic examination is still challenging.It needs to define the variation of cardiac anatomy and extracardiac structures such as:Cor triatriatum,membrane of left atrium and primary ASD with PFO.