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目的:探讨完全型心内膜垫缺损(ECD)尸检解剖的难点和技巧。方法:选取安贞医院病理科尸检诊断完全型ECD的14例病例,与产前超声检查诊断结果对比,观察心脏结构,并按Rastelli进行分型,明确房、室间隔缺损的范围,房室瓣发育、瓣膜及腱索附着情况,观察是否合并其他心内畸形及其他脏器畸形;并测量心脏各项指标。结果:14例完全型ECD:1按Rastelli分型,A型12例,B型1例,C型1例;2单一完全型ECD 2例,仅合并其他心内畸形者5例,仅合并其他脏器异常或畸形者2例,同时合并其他心内畸形及其他脏器异常或畸形者5例。313例与超声诊断相同,1例不符。结论:掌握完全型ECD的分步解剖技巧,提高尸检诊断准确率,对临床及超声诊断有一定的意义。
Objective: To investigate the difficulties and techniques of autopsy of complete endocardial cushion defect (ECD). Methods: A total of 14 cases of complete ECD diagnosed by pathological autopsy in Anzhen Hospital were selected. Compared with the results of prenatal ultrasound examination, the heart structure was observed and classified according to Rastelli. The range of atrial and ventricular septal defects was defined. Atrioventricular valve Development, valvular and chordae tendon attachment, observe whether other heart deformities and other organ deformities; and measure the heart indicators. Results: 14 cases of complete ECD: 1 according to Rastelli classification, type A in 12 cases, type B in 1 case, type C in 1 case; 2 single complete type ECD in 2 cases, only with other intracardiac malformations in 5 cases, only with other 2 cases of abnormal or abnormal organs, combined with other intracardiac malformations and other organs abnormalities or deformities in 5 cases. 313 cases with the same ultrasound diagnosis, 1 case does not match. Conclusion: To master the step-by-step dissection technique of complete ECD and improve the accuracy of autopsy diagnosis is of clinical significance and clinical significance.