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目的:该文旨在探讨超声心动图与心导管检查对先天性心脏病室间隔缺损(VSD)的定性与定量的诊断价值,为临床对VSD的诊断与治疗提供参数与依据。方法:经手术证实的35例VSD,与术前超声心动图、心导管检查结果进行对比研究。结果:该组病例中,二维超声检查22例,与手术对照诊断特异性95.5%(21/22,术中见VSD直径0.5~3.5cm),说明二维超声对直径0.5cm以上VSD的位置和大小的定性与定量诊断是可靠和准确的;心导管检查24例,与手术对照诊断符合率83.3%(20/24)。二维超声与心导管检查对VSD的术前诊断与手术诊断比较有显著意义(P<0.01)。该组病例术后一年无死亡,与心导管准确提供肺动脉压力密切相关,肺动脉压力与VSD大小之间关系密切,即肺动脉压力高VSD直径大;VSD并重度肺动脉高压患者,当肺动脉压力与周围动脉比值≤0.90时,手术效果好。结论:二维超声心动图与彩色多谱勒一样能对绝大多数VSD作出准确诊断;肺动脉压力与VSD关系密切。
OBJECTIVE: To investigate the value of qualitative and quantitative diagnosis of ventricular septal defect (VSD) in congenital heart disease by echocardiography and cardiac catheterization, and to provide the parameters and basis for the clinical diagnosis and treatment of VSD. Methods: 35 cases of VSD confirmed by surgery were compared with preoperative echocardiography and cardiac catheterization. Results: In this group of cases, two-dimensional ultrasonography was performed in 22 cases and the specificity was 95.5% (21/22, VSD 0.5 ~ 3.5cm) The qualitative and quantitative diagnosis of VSD was reliable and accurate. Cardiac catheterization was performed in 24 cases, which was 83.3% (20/24) in agreement with the surgical control. Two-dimensional ultrasound and cardiac catheterization in VSD preoperative diagnosis and surgical diagnosis were significant (P <0.01). One year after the operation, there was no death in this group, which was closely related to the accurate delivery of pulmonary artery pressure by cardiac catheter. The relationship between pulmonary artery pressure and VSD size was close, that is, the pulmonary artery pressure was high and VSD diameter was large. In patients with VSD and severe pulmonary hypertension, Arterial ratio ≤ 0.90, the operation effect is good. Conclusions: Two-dimensional echocardiography, like color Doppler, can accurately diagnose the vast majority of VSDs; pulmonary artery pressure is closely related to VSD.