摘要
目的探讨超声诊断先天性心脏病（CHD）合并感染性心内膜炎（IE）的临床价值,为临床提高CHD合并IE的诊断水平提供参考。方法回顾性分析2011年12月-2013年1月在医院治疗的25例CHD合并IE患者,所有患者均运用超声检查,分析其超声显示情况,对比手术病理检查情况,分析其诊断价值。结果 25例患者行超声检查共发现赘生物31例,其中以分别在主动脉瓣的最多,占48.4%,其次是肺动脉瓣占19.4%,肺动脉外侧瓣占16.1%,三尖瓣和左心室流出道最少,分别占9.7%和6.4%;IE赘生物的直径以10～25mm为主,在形态中又以条索状最常见,超声回声以强回声和弱回声为主,绝大多数赘生物活动是随心动周期来回摆动;而在赘生物引起周围病变中,以病变周围存在不同程度的心包积液最常见,瓣周脓肿仅存在于主动脉瓣内,而在连枷运动、瓣膜穿孔、瓣膜脱垂在主动脉中均存在,超声诊断赘生物的准确率达83.8%。结论超声心动图对心内原发畸形诊断准确率高,对于〉0.4cm的心内赘生物有较高诊断敏感性和准确性,对瓣膜穿孔、关闭不全等并发症可作出准确诊断,超声诊断CHD合并IE是主要依据。
OBJECTIVE To evaluate the clinical value of ultrasound diagnosis of congenital heart disease（CHD） complicated with infective endocarditis（IE）so as to improve the level of diagnosis of CHD complicated with IE. METHODS A retrospective survey was conducted for 25patients complicated with CHD and IE who were hospitalized from Dec 2011to Jan 2013,then the ultrasonography was performed for all the patients,ultrasound displays were observed,the findings of pathological examination were compared,and the diagnosis value was evaluated. RESULTS The result of the ultrasound examination showed that totally 31cases of vegetations were found among the 25 patients,among which the patients with the vegetations in aortic valve accounted for 48.4%,the patients with the vegetations in the pulmonary valve 19.4%,the patients with the vegetations in lateral disc of pulmonary artery 16.1%,the patients with the vegetations in tricuspid valve 9.7%,the patients with the vegetations in left ventricular outflow tract 6.4%.The IE vegetations with the diameter ranging between 10and 25mm were dominant,with the funicular form as the most common morphological form;the ultrasonic echos were given priority to the strong echo and weak echo.Most of the vegetations swung back and forth with the cardiac cycle.Among the peripheral lesions induced by the vegetations,the different degrees of pericardial effusion around the lesions was most common,the valve abscess existed only in aortic valve, and the flail motion,valvular perforation,and valve prolapse existed in aortic valve.The accuracy of ultrasound in diagnosis of neoplasm was 83.8%.CONCLUSIONThe accuracy of the echocardiography in diagnosis of primary cardiac abnormalities is high,with higher sensitivity and accuracy in diagnosis of cardiac vegetations with the diameter more than 0.4cm;the echocardiography can accurately diagnose the complications such as the valvular perforation and insufficiency,and the ultrasound diagnosis of CHD complicated with IE is the main basis.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第9期2203-2205,共3页
Chinese Journal of Nosocomiology
基金
湖北省卫生厅科研基金资助项目(JX5B06)
关键词
超声心动图
先天性心脏病
感染性心内膜炎
诊断价值
Echocardiography
Congenital heart disease
Infective endocarditis
Diagnostic value
