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目的研究超声心动图在诊断婴幼儿主动脉缩窄症中的应用情况。方法采用回顾性研究方法,选取2012年5月-2015年5月之间,洛阳中心医院诊断为主动脉缩窄的住院患儿46例,其中男性38例,女性8例。应用彩色多普勒超声诊断仪,对患儿进行超声心动图的全面检查。结果在46例患者中,通过超声心动图确诊39例,占84.78%,诊断准确率较高;有5例患者漏诊,占10.87%;有2例患者误诊,占4.35%。漏诊的患者诊断为主动脉峡部局限性狭窄和主动脉管状狭窄,误诊的患者诊断为主动脉弓离断。在超声心动图确诊的39例患者中,合并有其他心脏畸形患儿29例,占74.36%;其中存在动脉导管未闭畸形的19例,占48.72%,与其他畸形类型两两比较,差异有统计学意义(P<0.05,χ~2=34.787)。其他畸形类型包括室间隔缺损3例,占7.69%;房间隔缺损3例,占7.69%;主动脉瓣狭窄2例,占5.13%;房室共同通道2例,占5.13%。其他畸形类型组间两两比较,差异无统计学意义(P>0.05)。在超声心动图确诊的39例患者中,诊断为管状缩窄21例,占53.85%;主动脉弓局限性缩窄18例,占46.15%。两组间比较,差异无统计学意义(P>0.05,χ~2=16.375)。其中管状缩窄的患者,缩窄位置多在主动脉弓的峡部;主动脉弓局限性缩窄的患者,缩窄部位多在主动脉弓降部。结论超声心动图整体检查的准确率较高,动脉导管未闭是本病最高发的合并症,全面掌握超声心动图的原理和婴幼儿主动脉缩窄的病理生理,能够更有效地分析出诊断要点,从而显著提高诊断的准确率。
Objective To study the application of echocardiography in the diagnosis of aortic constriction in infants and young children. Methods A retrospective study was conducted to select 46 hospitalized children with aortic constriction in Luoyang Central Hospital between May 2012 and May 2015, including 38 males and 8 females. Application of color Doppler ultrasound diagnostic apparatus, a comprehensive examination of children with echocardiography. Results Of the 46 patients, 39 cases were diagnosed by echocardiography, accounting for 84.78%. The diagnostic accuracy was high. Five patients missed diagnosis, accounting for 10.87%. Two patients were misdiagnosed, accounting for 4.35%. Patients who missed the diagnosis of localized aortic isthmus stenosis and aortic stenosis, misdiagnosis of the diagnosis of aortic arch disconnection. Among the 39 patients confirmed by echocardiography, there were 29 cases with other cardiac malformations, accounting for 74.36%. There were 19 cases with patent ductus arteriosus, accounting for 48.72%. Compared with other deformities, the difference was Statistical significance (P <0.05, χ ~ 2 = 34.787). Other malformations included ventricular septal defect in 3 cases, accounting for 7.69%; atrial septal defect in 3 cases, accounting for 7.69%; aortic stenosis in 2 cases, accounting for 5.13%; atrioventricular common channel in 2 cases, accounting for 5.13%. There was no significant difference between other deformity groups (P> 0.05). Of the 39 patients diagnosed by echocardiography, 21 cases were diagnosed as tubular constriction, accounting for 53.85%. Aortic arch limitation was narrowed in 18 cases (46.15%). There was no significant difference between the two groups (P> 0.05, χ ~ 2 = 16.375). The narrowing of the patients, narrowing more in the aortic arch isthmus; aortic arch narrowing of the narrowing of patients, mostly in the aortic arch reduction. Conclusion The overall accuracy of echocardiography is high. Patent ductus arteriosus is the highest complication of the disease. To master the echocardiographic principle and the pathophysiology of aortic constriction in infants and young children, it can diagnose the diagnosis more effectively Points, thus significantly improving the diagnostic accuracy.