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目的探讨超声心动图在小腰型室间隔缺损封堵器闭合膜部室间隔缺损(perimembranous ventricular septal defect,PmVSD)中的应用价值。方法使用飞利浦Sonos-5500型彩色多普勒超声诊断仪,探头频率2~4MHz,对43例PmVSD患者术前、术中、术后进行超声心动图观测。结果超声心动图测得室缺缺损口左室侧均大于右室侧,多数伴右室侧多孔(多束分流)。缺损口形态为不规则形或瘤形。②心血管造影测量缺损口左右室侧大小并与超声测量值比较,结果无显著性差异。③封堵器型号为4~14(7.7±2.5)mm,1例释放后出现少量残余分流,术后3d消失,余成功封堵;3例少量三尖瓣返流,近期随访观察未见明显异常。结论PmVSD缺损口形态复杂,变异较大,超声心动图指导应用小腰型封堵器闭合可获得满意的近期疗效。
Objective To investigate the value of echocardiography in the occlusion of perimembranous ventricular septal defect (PmVSD) in small lumbar ventricular septal defect occluder. Methods The Philips Sonos-5500 color Doppler ultrasound scanner was used. The frequency of the probe was 2 ~ 4MHz. Echocardiography was performed on 43 patients with PmVSD before, during and after surgery. Results Echocardiography showed that the ventricular defect was larger in the left ventricular side than in the right ventricular side and most in the right ventricular side with multiple shunts. Defect mouth shape is irregular or tumor-shaped. ② cardiovascular angiography to measure the size of the left and right ventricular defect and compared with the ultrasound measurements, the results no significant difference. ③ The type of occluder was 4 ~ 14 (7.7 ± 2.5) mm. A small amount of residual shunt occurred after 1 case was released and 3d disappeared after operation, while the other cases successfully blocked. A small amount of tricuspid regurgitation was observed in 3 cases abnormal. Conclusions The morphology of PmVSD defect is complex and has a large variation. Echocardiography can be used to guide the application of a small occlusion device to achieve satisfactory short-term curative effect.