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目的探讨超声心动图在右肺动脉异常起源于主动脉(anomalous origin of the right pulmonary artery from ascending aorta,AORPA)中的诊断价值。方法回顾性分析经超声心动图诊断的25例AORPA患者临床和超声心动图资料。结果 24例患者超声心动图诊断结果与手术诊断结果相符,1例患者漏诊动脉导管未闭;近端型18例,右肺动脉内径为(13.6±3.4)mm,肺动脉收缩压为(112.3±16.5)mm Hg;远端型7例,右肺动脉内径为(14.1±3.0)mm,肺动脉收缩压为(112.1±20.0)mm Hg;24例行手术治疗,1例放弃手术治疗;25例均合并重度肺动脉高压、右心增大及不同程度三尖瓣关闭不全;合并动脉导管未闭者21例,室间隔缺损者5例,房间隔缺损/卵圆孔未闭者5例,法洛四联症者1例,二尖瓣关闭不全者1例,重度三尖瓣关闭不全者3例;超声心动图表现为主肺动脉分叉结构消失,肺动脉主干仅与左肺动脉延续,右肺动脉起源于主动脉。结论超声心动图在AORPA中诊断率较高,有助于早期临床确诊和尽早手术治疗,可作为诊断AORPA的首选方法。
Objective To investigate the diagnostic value of echocardiography in anomalous origin of the right pulmonary artery from ascending aorta (AORPA). Methods The clinical and echocardiographic data of 25 AORPA patients diagnosed by echocardiography were retrospectively analyzed. Results The echocardiographic results of 24 patients were consistent with the results of surgery. One patient had missed patent ductus arteriosus. In 18 patients with proximal type, the diameter of the right pulmonary artery was (13.6 ± 3.4) mm and the systolic pressure of the pulmonary artery was (112.3 ± 16.5) mm Hg; distal type in 7 cases, right pulmonary artery diameter (14.1 ± 3.0) mm, pulmonary systolic pressure (112.1 ± 20.0) mm Hg; 24 cases of surgical treatment, 1 case of giving up surgery; 25 cases were complicated with severe pulmonary artery High pressure, right heart increased and varying degrees of tricuspid regurgitation; 21 cases with patent ductus arteriosus, ventricular septal defect in 5 cases, atrial septal defect / patent foramen ovale in 5 cases, tetralogy of Fallot 1 case, mitral regurgitation in 1 case, severe tricuspid regurgitation in 3 cases; echocardiography showed the main pulmonary artery bifurcation structure disappeared, pulmonary artery trunk only with the left pulmonary artery, the right pulmonary artery originated in the aorta. Conclusions Echocardiography has a higher diagnosis rate in AORPA, which is helpful for early clinical diagnosis and early surgical treatment. It may be the first choice to diagnose AORPA.