器官移植
器官移植
기관이식
OGRAN TRANSPLANTATION
2015年
1期
46-50
,共5页
超声心动描记术%原位心脏移植%左心室Tei指数%三尖瓣反流%心包积液
超聲心動描記術%原位心髒移植%左心室Tei指數%三尖瓣反流%心包積液
초성심동묘기술%원위심장이식%좌심실Tei지수%삼첨판반류%심포적액
Echocardiography%Orthotopic heart transplantation%Left ventricle Tei index%Tricuspid regurgitation%Pericardial effusion
目的：探讨应用超声心动图在原位心脏移植术后的早期应用价值。方法应用超声心动图对29例原位心脏移植术后患者进行早期监测，于术后1、7、14、30 d 记录左心室舒张末径（LVDd）、右心室舒张末径（RVDd）、室间隔厚度（IVST）、左心室后壁厚度（LVPWT）和三尖瓣反流面积，并计算左心室射血分数（LVEF）、左心室Tei指数（LV-Tei）。同时记录患者血压、中心静脉压（CVP）。结果与术后1 d比较，术后7、14、30 d的LVDd均较大，RVDd均较小（均为P＜0.05）。与术后7 d比较，术后1、14、30 d的IVST、LVPWT数值均较低（均为P＜0.05）。与术后7 d比较，术后1、14、30 d的血压、CVP、LV-Tei数值均较低，差异有统计学意义（均为P＜0.05）；各时间点LVEF比较差异无统计学意义（均为P＞0.05）。超声心动图检查于术后3～4 d发现三尖瓣反流，三尖瓣反流面积于术后5～8 d达最大面积（9.2±2.5）cm2，此后反流面积逐渐减少，术后1个月时减少至（4.7±2.4） cm2。结论在原位心脏移植术后早期，应用超声心动图可有效监测移植心脏的结构及功能情况，及时为临床医师提供多种参数作为诊疗的依据。
目的：探討應用超聲心動圖在原位心髒移植術後的早期應用價值。方法應用超聲心動圖對29例原位心髒移植術後患者進行早期鑑測，于術後1、7、14、30 d 記錄左心室舒張末徑（LVDd）、右心室舒張末徑（RVDd）、室間隔厚度（IVST）、左心室後壁厚度（LVPWT）和三尖瓣反流麵積，併計算左心室射血分數（LVEF）、左心室Tei指數（LV-Tei）。同時記錄患者血壓、中心靜脈壓（CVP）。結果與術後1 d比較，術後7、14、30 d的LVDd均較大，RVDd均較小（均為P＜0.05）。與術後7 d比較，術後1、14、30 d的IVST、LVPWT數值均較低（均為P＜0.05）。與術後7 d比較，術後1、14、30 d的血壓、CVP、LV-Tei數值均較低，差異有統計學意義（均為P＜0.05）；各時間點LVEF比較差異無統計學意義（均為P＞0.05）。超聲心動圖檢查于術後3～4 d髮現三尖瓣反流，三尖瓣反流麵積于術後5～8 d達最大麵積（9.2±2.5）cm2，此後反流麵積逐漸減少，術後1箇月時減少至（4.7±2.4） cm2。結論在原位心髒移植術後早期，應用超聲心動圖可有效鑑測移植心髒的結構及功能情況，及時為臨床醫師提供多種參數作為診療的依據。
목적：탐토응용초성심동도재원위심장이식술후적조기응용개치。방법응용초성심동도대29례원위심장이식술후환자진행조기감측，우술후1、7、14、30 d 기록좌심실서장말경（LVDd）、우심실서장말경（RVDd）、실간격후도（IVST）、좌심실후벽후도（LVPWT）화삼첨판반류면적，병계산좌심실사혈분수（LVEF）、좌심실Tei지수（LV-Tei）。동시기록환자혈압、중심정맥압（CVP）。결과여술후1 d비교，술후7、14、30 d적LVDd균교대，RVDd균교소（균위P＜0.05）。여술후7 d비교，술후1、14、30 d적IVST、LVPWT수치균교저（균위P＜0.05）。여술후7 d비교，술후1、14、30 d적혈압、CVP、LV-Tei수치균교저，차이유통계학의의（균위P＜0.05）；각시간점LVEF비교차이무통계학의의（균위P＞0.05）。초성심동도검사우술후3～4 d발현삼첨판반류，삼첨판반류면적우술후5～8 d체최대면적（9.2±2.5）cm2，차후반류면적축점감소，술후1개월시감소지（4.7±2.4） cm2。결론재원위심장이식술후조기，응용초성심동도가유효감측이식심장적결구급공능정황，급시위림상의사제공다충삼수작위진료적의거。
Objective To investigate the early application value of echocardiography (UCG)after orthotopic heart transplantation (OHT). Methods A total of 29 patients were monitored by UCG early after OHT. On the 1st,7th,14th,30th day after operation,the left ventricular end-diastolic diameter (LVDd)and right ventricular end-diastolic diameter (RVDd),interventricular septal thickness (IVST),left ventricular posterior wall thickness (LVPWT)and the tricuspid regurgitation area (TRA)were measured,and the left ventricular ejection fraction (LVEF ) and left ventricle Tei index (LV-Tei ) were calculated. The blood pressures (BP),central venous pressure (CVP)of the patients were recorded simultaneously. Results The LVDd were larger on the 7th,14th and 30th day after operation,while the RVDd were smaller,compared with those on the 1st day after operation (all in P<0.05). The IVST,LVPWT were lower on the 1th,14th and 30th day after operation,compared with those on the 7th day after operation (all in P<0.05). The BP,CVP,LV-Tei were all significantly lower on the 1st,14th and 30th day after operation,compared with those on the 7th day after operation (P<0.05 ). There was no significant difference in LVEF between each time points(P>0.05 ).The tricuspid regurgitation was detected in 3-4 d after operation by UCG,and the TRA reached the peak value [(9.2 ±2.5)cm2]in 5-8 d after operation,then gradually decreased to (4.7 ±2.4)cm2 at 1 month after operation. Conclusions Early phase after OHT,the structure and function of transplanted heart can be monitored effectively by echocardiography,and it can timely provide multiple parameters as the basis of diagnosis and treatment for clinical doctors.
