摘要
为了对比超声心动图与心导管检查在心脏外科术前诊断中的诊断准确性，我们回顾性地分析了１９８６年到１９９４年９年间在我院心脏外科行手术治疗患者的手术记录，超声和心导管报告。手术前既行心导管又行超声检查的患者共２１７例，其中先心病２１０例（９６．７７％）；瓣膜病４例（１．８４％）；冠心病和预激综合征３例（１．３８％）。术前诊断中心导管检查的例数随年度逐渐降低（ｒ＝－０．９２１）；以手术所见为标准计算了超声和心导管的术前诊断准确率，超声正确而心导管误诊者２１例（９．６８％），心导管正确而超声误诊者１１例（５．０７％），两者均误诊者５例（２．３０％）。配对卡方检验结果表明：超声与心导管诊断有相关关系（Ｐ＜０．０５），两者的诊断准确率无显著性差异（Ｐ＞０．０５）。超声的诊断准确率为９２．６３％，心导管的诊断准确率为８８．０２％，两者联合诊断的诊断准确率为９７．９７％。经两个率的卡方检验可以认为联合诊断的诊断准确率高于单独一个诊断方法（Ｐ＜０．００１）。结论：在以先心病、瓣膜病为主体的心脏外科手术患者中，超声至少有与心导管检查相同的术前诊断准确率，从而无需再行创伤性的心导管检查；但在患有复杂先心病的少数患者，最好联合使用?
To compare the preoperative diagnostic accuracy of echocardiography (ECHO) and cardiac catheterization (CATH),the surgical records from 1986 to 1994 in our hospital were retrospectively analyzed and the diagnoses of ECHO and CATH were compared with surgical findings,respectively.A total of 217 cases underwent both ECHO and CATH examinations,of whom 210 cases had congenital heart disease (96 77%),4 had valvular heart disease (1.84%) and 3 had coronary artery disease cardiac arrhythmia (1.29%).The number of patients who underwent preoperative CATH examination has a significant negative correlation to the year (r=-0.921).Compared with surgical findings,misdiagnoses by ECHO occurred in 16(7.37%) cases and by CATH in 26 (11.98%) cases.In 21 (9.68%) cases the diagnoses by ECHO were right while those by CATH were wrong,in 11 (5.07%) cases the diagnoses by ECHO were wrong while those by CATH were right and in 5 (2.03%) cases diagnoses by both techniques were wrong.There was no significant difference of misdiagnoses between the two techniques.The diagnostic accuracy of ECHO and CATH was 92.63% and 88.02%,respectively.At the same time, the diagnostic accuracy of combined ECHO and CATH was 97.97% which was significantly higher than that of either ECHO or CATH alone ( P <0.001).Conclusions:In the majority of patients with congenital and valvular heart disease,ECHO is as accurate as CATH in the preoperative diagnosis,thus obviating the need for invasive studies.However,in the minority of patients with complex congenital heart disease,combined use of ECHO and CATH is advisable to achieve a high diagnostic accuracy.
出处
《中国医学影像技术》
CSCD
北大核心
1997年第3期201-203,共3页
Chinese Journal of Medical Imaging Technology
关键词
心脏手术
心导管检查
超声心动图
Echocardiography\ \ Cardiac catheterization\ \ Heart surgery
