CAJ | 학술논문

目的：探讨右室双出口（ DORV）的超声心动图表现特征及鉴别诊断要点，提高术前超声诊断的准确率。方法回顾性分析2008年5月至2011年8月年在商丘市第一人民医院经手术确诊并矫治的右室双出口患者27例，其中法洛四联症型18例，艾森曼格型5例，右位型大动脉异位型（ D-malposition）即Taussig-Bing综合征3例，左位型大动脉异位型（ L-malposition）1例。术前全部经超声心动图检查。结果18例法洛四联症型双出口患者中11例确诊，有7例经手术由法洛四联症修正诊断为法洛四联症型右室双出口。5例艾森曼格型中有2例确诊，3例由室间隔缺损合并肺动脉高压修正诊断为右室双出口。Taussig-Bing综合征3例及左位型大动脉异位型1例均确诊。所有患者全部经外科手术证实并实施矫治术。结论右室双出口因为分型不同而在超声心动图表现方面有各自不同的特征，并且与法洛四联症、室间隔缺损合并肺动脉高压以及大动脉转位之间在诊断上有交叉，因此超声心动图诊断时要严格区分，尽量避免误诊。
목적：탐토우실쌍출구（ DORV）적초성심동도표현특정급감별진단요점，제고술전초성진단적준학솔。방법회고성분석2008년5월지2011년8월년재상구시제일인민의원경수술학진병교치적우실쌍출구환자27례，기중법락사련증형18례，애삼만격형5례，우위형대동맥이위형（ D-malposition）즉Taussig-Bing종합정3례，좌위형대동맥이위형（ L-malposition）1례。술전전부경초성심동도검사。결과18례법락사련증형쌍출구환자중11례학진，유7례경수술유법락사련증수정진단위법락사련증형우실쌍출구。5례애삼만격형중유2례학진，3례유실간격결손합병폐동맥고압수정진단위우실쌍출구。Taussig-Bing종합정3례급좌위형대동맥이위형1례균학진。소유환자전부경외과수술증실병실시교치술。결론우실쌍출구인위분형불동이재초성심동도표현방면유각자불동적특정，병차여법락사련증、실간격결손합병폐동맥고압이급대동맥전위지간재진단상유교차，인차초성심동도진단시요엄격구분，진량피면오진。
Objective To investigate the common misdiagnosis reason and differential diag-nosis of patients with double outlet right ventricle( DORV ) diagnosed by ultrasonic cardiogram. Methods Twenty-seven patients with DORV admitted at the first people ’s hospital of Shangqiu from May 2008 to August 2011 were retrospectively analyzed. Eighteen cases of them were tetralogy of Fallot,5 cases of them were Eisenmenger type,3 cases of them were right artery ectopic( D-malposition, Taussig-Bing symptom)and 1 case of them was left artery ectopic( L-malposition). Results Eleven ca-ses with tetralogy of Fallot were confirmed and 7 cases with tetralogy of Fallot were corrected to DORV of tetralogy of Fallot. Two patients with Eisenmenger were confirmed and 3 patients with ventricular septal defect combined pulmonary hypertension were corrected to DORV. All patients with Taussig-Bing symp-tom and left artery ectopic were confirmed. All patients were performed with surgical operation. Conclu-sions There are different characteristics on supersonic and enchanted because of different types for pa-tients with DORV and it overlapped with tetralogy of Fallot,ventricular septal defect combined pulmonary hypertension and transposition of the great arteries. Therefore we should strictly distinguish them and try to avoid the misdiagnosis.