下腔静脉和肝静脉超声心动图及其临床应用

本文提出下腔静脉测量的稳定方法是:在其远段管壁平行处记录 M 型心动图测量呼气相 a 波内径。20～59岁成人下腔静脉内径正常值为19.56±3.13mm,7～19岁青少年为11.29±2.12mm/m~2。20～59岁成人肝静脉内径正常值为6.69±1.64mm,7～19岁青少年4.35±1.07mm/m~2。心衰、三尖瓣关闭不全和房间隔缺损均可导致肝静脉扩张。肝静脉内径在反映心功能和右心血流动力学方面较下腔静脉敏感。本文提出肝静脉声学血流图(肝静脉微泡流线图)的概念、描记方法及时相测量,并认为它比下腔静脉声学造影的 M型心动图敏感而准确。正常人97.7%可在肝静脉内出现造影剂返流。肝静脉内返流第一峰终点延迟或第二峰起点提前可诊断三尖瓣关闭不全。当排除心衰因素后,第二峰终点延迟有助于诊断房间隔缺损。

In Ferior Vena Cava and Hepatic Vein Echocardiography and the Clinical Application

The diameters of“a”wave of expiration of 140 normal subjects were recorded by M-mode echocardiography at the distal portion of IVCD.The normal range is 19.56±3.13mm in the group of age 20-59; 11.29±2.12mm/m² in the group of age 7-19.The normal range of the hepatic vein diameter(HVD)was measured at expiration and systole is 6.69±1.64mm in the group of age 20-59;4.35±1.07mm/m² in the group of age 7-19.In patients with heart failure,tricuspid regurtation (TR)and septal defect(SD).The mean value of HVD is significantly different from the normal.The backflow of tracing are presented in the hepatic vein of 97.7% of normal subjects.The peaks of the backflow were applied for the TRand ASD diagnosis.