经食管与经胸超声心动图造影在检测隐源性脑卒中及偏头痛患者卵圆孔未闭右向左分流的效果比较

来源 :广西医科大学学报 | 被引量 : 0次 | 上传用户:JESSEA11
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目的:对比经食管超声心动图造影(TEE)、经胸超声心动图造影(TTE)在检测隐源性脑卒中及偏头痛患者卵圆孔未闭右向左分流(PFO-RLS)的效果。方法:选取2015年4月至2016年4月延安大学咸阳医院收治的隐源性脑卒中及偏头痛伴PFO-RLS患者50例,所有患者均先、后进行TTE和TEE造影,TTE造影检测频率为2~4 MHz,TEE造影检测频率为7 MHz。对比两种检查方法对于隐源性脑卒中及偏头痛患者的PFO-RLS检出率、半定量分流分级程度、检查准确率及造影并发症发生率。结果:TTE造影对PFO-RLS的检出率、半定量分级均显著高于TEE造影,差异有统计学意义(均P<0.05)。TTE造影无并发症及不适症状,且显著低于TEE造影的并发症发生率(P<0.05)。TTE造影检出PFO-RLS的特异度、灵敏度及准确率也显著高于TEE(P<0.05)。结论:TTE造影对隐源性脑卒中及偏头痛患者PFO-RLS检出率及准确率高,并发症少,半定量分流程度更精确,较TEE造影技术更具优势,值得临床推广应用。 Objective: To compare the effects of transesophageal echocardiography (TEE) and transthoracic echocardiography (TTE) in the detection of patent foramen ovale right-to-left shunt (PFO-RLS) in patients with cryptogenic stroke and migraine. Methods: From April 2015 to April 2016, 50 patients with cryptogenic stroke and migraine with PFO-RLS were enrolled in Xianyang Hospital, Yan’an University. TTE and TEE imaging and TTE imaging were performed in all patients. For 2 ~ 4 MHz, TEE contrast detection frequency is 7 MHz. Comparing the detection rate of PFO-RLS, semi-quantitative shunt grading, examination accuracy and incidence of contrast-induced complications in patients with cryptogenic stroke and migraine compared with the two methods. Results: The detection rate and semi-quantitative classification of PFO-RLS by TTE angiography were significantly higher than TEE angiography (all P <0.05). There was no complication or discomfort in TTE contrast and the incidence of complications was significantly lower than that of TEE (P <0.05). The specificity, sensitivity and accuracy of PFO-RLS detected by TTE were also significantly higher than those of TEE (P <0.05). Conclusion: The detection rate and accuracy of PFO-RLS in patients with cryptogenic stroke and migraine are higher than those without. Complication is less and the degree of semi-quantitative shunt is more accurate than TEE. It is worthy of clinical application.
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