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目的应用超声心动图多技术联合评价右心功能,分析影响右心功能的指标,旨在为临床评估无症状和轻微症状肺栓塞(NSPE)提供快速可靠的诊断依据;对患者的预防、早期诊断、规范化治疗、预后评估提供有力依据,争取获得确切的学术价值和良好的社会效益。方法选取2014年6月—2015年12月入住唐山市工人医院集团妇产科、骨科、神经外科围术期患者;ICU、风湿科、康复科患者,临床评估均有肺动脉栓塞风险,共计56例。最终以CT肺动脉造影(CTPA)结果分为肺栓塞组(26例)及无肺栓塞组(30例)。分析1二组间超声心动图指标变化;2肺栓塞组发病前、发病后6h内、治疗后72h内及一周后的超声心动图指标变化。结果肺栓塞组6h内与无肺栓塞组相比较,RVAWTd、RVAWTs、RADD、RVOT、MPAD、RVEDd、RVEDs,差异无统计学意义(P>0.05);肺栓塞组6h内右心室Tei指数、Em、Am、RVEDV、RVESV与无肺栓塞组比较呈增高状态,TAPSE、Em/Am、RVEF比值呈减低状态,差异具有统计学意义(P<0.05);肺栓塞组治疗前、治疗后72h及一周后TRV、TRPG、SPAP明显减小,差异具有统计学意义(P<0.05)。结论超声心动图多技术联合应用可为临床NSPE提供有力诊断依据,并能准确无创地评价右心功能;超声心动图多技术联合应用可为NSPE的临床疗效进行评估。
Objective To evaluate the right heart function by echocardiography and analyze the influencing indexes of right heart function so as to provide a fast and reliable diagnosis basis for clinical evaluation of asymptomatic and minor symptoms of pulmonary embolism (NSPE). The prevention, early diagnosis , Standardized treatment, prognosis assessment to provide a strong basis for access to the exact academic value and good social benefits. Methods From June 2014 to December 2015, patients admitted to Department of Obstetrics and Gynecology, Orthopedics and Neurosurgery in Tangshan Workers’ Hospital Group were enrolled in this study. Patients in ICU, rheumatology department and rehabilitation department were all included in the clinical evaluation of pulmonary embolism. There were 56 cases . Finally, CT pulmonary angiography (CTPA) results were divided into pulmonary embolism group (26 cases) and no pulmonary embolism group (30 cases). The echocardiographic parameters of the two groups were analyzed. The echocardiographic parameters of the pulmonary embolism group before onset, within 6 hours after onset, within 72 hours after treatment and after one week were analyzed. Results There was no significant difference in RVAWTd, RVAWTs, RVD, RVOT, MPAD, RVEDd and RVEDs between 6 h after pulmonary embolism and without pulmonary embolism (P> 0.05) , Am, RVEDV and RVESV increased compared with those without pulmonary embolism, and the ratios of TAPSE, Em / Am and RVEF decreased. The difference was statistically significant (P <0.05); before embolization, 72h and one week After TRV, TRPG, SPAP was significantly reduced, the difference was statistically significant (P <0.05). Conclusion The combination of echocardiography and multi-technique can provide a powerful diagnostic basis for clinical NSPE, and can accurately and noninvasively evaluate right heart function. The combination of echocardiography and multi-technique can evaluate the clinical efficacy of NSPE.