CAJ | 학술논문

目的探讨经胸实时超声监测肺动脉跨瓣压差(TPG)在经皮穿刺球囊肺动脉瓣成形术(PBPV)中的价值.方法对80例肺动脉瓣不同狭窄程度的患者进行PBPV手术,在手术的不同时段测量肺动脉瓣环内径及肺动脉跨瓣压差(TPG).结果超声测量及造影测量肺动脉瓣环直径比较差异无统计学意义(t=2.013,P＞0.05).扩张前后超声测压与术中导管测压比较差异均无统计学意义(t=1.258,P＞0.05).不同程度的肺动脉瓣狭窄患者TPG在球囊导管扩张术后明显降低(P＜0.01).轻度肺动脉瓣狭窄球囊扩张两次即可达到手术评优指标；中重度肺动脉瓣狭窄需要球囊扩张三次.结论超声实时测量TPG对PBPV手术有指导作用.
목적 탐토경흉실시초성감측폐동맥과판압차(TPG)재경피천자구낭폐동맥판성형술(PBPV)중적개치.방법 대80례폐동맥판불동협착정도적환자진행PBPV수술,재수술적불동시단측량폐동맥판배내경급폐동맥과판압차(TPG).결과 초성측량급조영측량폐동맥판배직경비교차이무통계학의의(t=2.013,P＞0.05).확장전후초성측압여술중도관측압비교차이균무통계학의의(t=1.258,P＞0.05).불동정도적폐동맥판협착환자TPG재구낭도관확장술후명현강저(P＜0.01).경도폐동맥판협착구낭확장량차즉가체도수술평우지표；중중도폐동맥판협착수요구낭확장삼차.결론 초성실시측량TPG대PBPV수술유지도작용.
Objective To assess the value of transvalvular pressure gradient (TPG) by use of realtime color Doppler echocardiography in percutaneous balloon pulmonary valvuloplasty (PBPV).Methods Patients with pulmonic stenosis (80 cases) were performed by PBPV,in which the pilmonic annular diameter and TPG were measured by using of 2-D and color Doppler echocardiography in the different periods of this operation.Results The pilmonic annular diameter was not significantly difference by intraoperative echocardiography and radiography measurement (t =2.013,P ＞ 0.05).And pressure measurement by catheterization pre- and post-dilatation was not markedly significant ( t =1.258,P ＞0.05).However,TPG in patients with the different degree of pulmonic stenosis were decreased significantly ( P ＜0.01).PBPV treatments in the mild pulmonic stenosis for twice got an excellent effect according to operation criteria,but PBPV treatment in patients with the moderate and severe pulmonic stenosis need to be done for three times.Conclusions Real-time color Doppler echocardiography is an effective way and plays a guiding role in PBPV.