论文部分内容阅读
目的探讨超声心动图对左心房黏液瘤患者分级评价的价值。方法本研究回顾性搜集2010～2011年在复旦大学附属中山医院行左心房黏液瘤切除术患者48例,分别对超声心动图评价肿瘤内径最大值与术中测量结果及术前肺动脉收缩压行相关性分析,据轻度肺动脉高压标准(肺动脉收缩压40mmHg)对应的肿瘤内径最大值,将患者分为两组(A组、B组),对比手术前后组内变化及组间超声心动图指标差异。结果超声心动图测量肿瘤最大径与术中测量值相关性较好(r=0.78,P<0.01),与肺动脉收缩压有相关性(r=0.55,P<0.01)。A组与B组患者性别、年龄、术前临床症状、差异无统计学意义(P>0.05),术前组间左心房前后径(P<0.01)、左心室收缩末前后径(P<0.05)及肺动脉收缩压(P<0.01)差异有统计学意义;术后组间左心房前后径(P<0.05)及三尖瓣反流程度(P<0.01)差异有统计学意义。A组术后左心房前后径较术前缩小,差异有统计学意义(P<0.01),B组术后主动脉窦部内径(P<0.01)、左心房前后径(P<0.01)、左心室舒张末前后径(P<0.05)及肺动脉收缩压(P<0.01)较术前减小、二尖瓣及三尖瓣反流程度较术前降低(P均<0.01)。结论左心房黏液瘤患者肺动脉收缩压与瘤体最大径相关;瘤体最大径32.57mm可以作为患者病情的简单分级标准;左心房黏液瘤患者术后预后好,超声心动图在左心房黏液瘤术前分级评价及术后随访中有不可替代的辅助价值。
Objective To investigate the value of echocardiography in the classification of patients with left atrial myxoma. Methods This study retrospectively collected from 2010 to 2011 in Zhongshan Hospital Affiliated to Fudan University, left atrial myxoma resection in 48 patients, were evaluated echocardiography maximum diameter of the tumor with intraoperative measurements and preoperative pulmonary artery systolic pressure related According to the analysis of mild pulmonary hypertension (pulmonary arterial systolic pressure 40mmHg) corresponding to the maximum diameter of the tumor, the patients were divided into two groups (A group, B group), before and after surgery compared intra-group changes and inter-group echocardiographic parameters . Results The echocardiographic measurement showed that the maximum diameter of the tumor correlated well with the intraoperative measurement (r = 0.78, P <0.01) and was correlated with pulmonary artery systolic pressure (r = 0.55, P <0.01). There were no significant differences in gender, age and preoperative clinical symptoms between group A and group B (P> 0.05), anteroposterior diameter of left atrium (P <0.01), anteroposterior diameter of left ventricular contraction (P <0.05) ) And pulmonary systolic pressure (P <0.01). There was significant difference in anteroposterior diameter of left atrium (P <0.05) and degree of tricuspid regurgitation (P <0.01) between the two groups after operation. In group A, the anteroposterior diameter of left anterior descending was significantly lower than that before operation (P <0.01). The diameter of aortic sinus (P <0.01), anteroposterior diameter of left atrium (P <0.01) Ventricular end diastolic anteroposterior diameter (P <0.05) and pulmonary artery systolic pressure (P <0.01) decreased compared with preoperative, mitral and tricuspid regurgitation was lower than preoperative (P <0.01). Conclusion Pulmonary arterial systolic pressure in patients with left atrial myxoma is related to the maximum diameter of the tumor. The maximal diameter of 32.57mm can be used as a simple grading criterion for patients with left atrial myxoma. The prognosis of patients with left atrial myxoma is good. Echocardiography in left atrial myxoma Pre-grade evaluation and postoperative follow-up have irreplaceable auxiliary value.