摘要: |
目的 探讨急性暴发性心肌炎患儿的超声表现,应用体外膜肺氧合(Extracorporeal Membrane Oxygenation ,ECMO)治疗后心脏功能指标的变化以及对术后相关并发症的监测。方法 选取2017年1月至2021年11月在解放军总医院第七医学中心的21例急性暴发性心肌炎患儿应用ECMO治疗并成功脱机的,观察治疗前后的心脏参数的变化及相关并发症,结果ECMO治疗前和ECMO撤离即刻超声心动图指标的比较,左室射血分数,二尖瓣前叶运动速度,左室流出道速度时间积分升高,左室壁厚度,左室舒张末期内径,左房内径减小,肺动脉压下降,差异有统计学意义(P<0.01)。17例患儿表现为左室壁增厚,心肌回声减低,12例患者出现少量心包积液,16例有瓣膜少量反流。相关并发症包括静脉插管位置不当3例,插管位置渗血5例,颈动脉插管处假性动脉瘤1例,插管于右房入口血栓1例,脑组织损伤1例。结论 超声检查在急性暴发性心肌炎诊断,ECMO治疗过程中监测评估心脏功能的变化及并发症的判别中具有重要价值。 |
关键词: 超声 急性暴发性心肌炎 体外膜肺氧合 左心功能 并发症 |
DOI: |
投稿时间:2022-03-27修订日期:2022-12-01 |
基金项目:全军后勤科研重点项目资助(BLJ18J006) |
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Application of Ultrasound monitor in extracorporeal membrane oxygenation therapy in chidren with acute fulminant myocarditis |
Liumei,Wang jianhua,Zhao zhe,Wang zhe,Hong xiaoyang |
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Abstract: |
Objective: To investigate the application value of Ultrasound after Extracorporeal Membrane Oxygenation(ECMO)in patients with Acute fulminant myocerditis (AFM). Methods: 21 patients were admitted in PLA General hospital seventh medical center from January 2017 to November 2021. All patients accepted with Veno-arterial extracorporeal membrane Oxygenation(ECMO), complications associated with ECOMO and clinical outcome were documented. Ultrasound were performed before and during period of treatment. Results echocardiography parameter after ECMO implantation including left ventricular ejection fraction (LVEF). Left ventricular outflow tract velocity time integral(LVOT VTI), Tissue Doppler Imagine of anterior mitral leaflet(AMV DTI)increased significantly (p<0.01) , while Left ventricular diastolic diameter(LVDD), Left atrial diameter(LAD),Left ventricular wall thickness(LVWT), Pulmonary aterial pressure decreased (p<0.01),there was no difference in Right ventricular diastolic diameter (RVDD). Conclusion: Ultrasound can make an irreplaceable in diagnosis of AFM and can monitor its cardiac function effectively. |
Key words: Ultrasound Acute fulminant myocarditis Extracorporeal membrane oxygenation Left cardiac function Complications |