CAJ | 학술논문

目的总结肺动脉闭锁的超声心动图特点及诊断要点，提高对本病的诊断准确率。方法回顾性分析 36 例经手术证实的肺动脉闭锁患者的超声心动图资料。结果二维心动图各切面均不易显示发育不良的主肺动脉，联合运用彩色及连续波多普勒有助于对本病的诊断；依据室间隔完整性可将肺动脉闭锁分为室间隔完整型和室间隔缺损型：前者主动脉与肺动脉关系大多正常，后者动脉关系可转位或正常并易误诊为法洛四联征或右室双出口合并肺动脉狭窄。肺动脉血流主要来源于未闭动脉导管或(和)体肺侧支血管。结论超声心动图可以确诊肺动脉闭锁。在超声探测中应注意观察肺动脉闭锁的水平、左右肺动脉有无融合、肺血管及右室发育状况、肺血来源以及合并其他心内畸形等，以便正确指导外科手术的筛选及术式选择。
목적총결폐동맥폐쇄적초성심동도특점급진단요점，제고대본병적진단준학솔。방법회고성분석 36 례경수술증실적폐동맥폐쇄환자적초성심동도자료。결과이유심동도각절면균불역현시발육불량적주폐동맥，연합운용채색급련속파다보륵유조우대본병적진단；의거실간격완정성가장폐동맥폐쇄분위실간격완정형화실간격결손형：전자주동맥여폐동맥관계대다정상，후자동맥관계가전위혹정상병역오진위법락사련정혹우실쌍출구합병폐동맥협착。폐동맥혈류주요래원우미폐동맥도관혹(화)체폐측지혈관。결론초성심동도가이학진폐동맥폐쇄。재초성탐측중응주의관찰폐동맥폐쇄적수평、좌우폐동맥유무융합、폐혈관급우실발육상황、폐혈래원이급합병기타심내기형등，이편정학지도외과수술적사선급술식선택。
Objective　To improve the echocardiographic diagnostic accuracy of pulmonary atresia by summarizing its characteristics.Methods　The data of two-dimensional and Doppler echocardiography in 36 patients with pulmonary atresia confirmed by operation were analysed retrospectively.Results　It was very difficult to show the dysplastic main pulmonary artery by two-dimensional echocardiography in patients with pulmonary atresia, however color Doppler flow image and continue Doppler spectra could provide agreat help to detect them. The patients with pulmonary atresia could be divided into two categories based on their integrity of interventricular septum. The patients with pulmonary atresia and intact interventricular septum always had normal connection of great arteries. The patients with pulmonary atresia and ventricular septal defect could be with either normal or transposition of great arteries, which sometimes could be mistaken as tetralogy of Fallot or double outflow of right ventricle accompanied with pulmonary stenosis if neglecting their echocardiographic characteristics.Conclusions　Pulmonary atresia can be diagnosed accurately by echocardiography. To assist operator to determine the operation approach and method, echocardiographic diagnosis should include following main points as the location of atresia, the convergence of left and right pulmonary arteries, the development of right ventricle and pulmonary vessel, the resource of pulmonary blood and other accompanied abnormalities.