摘要
目的 比较电子束CT(EBCT)测定冠状动脉搭桥手术 (CABG)前后心功能相关指标的变化 ,对手术效果进行评价。方法 术前全组 2 2例患者均行EBCT测定心功能指标 :左室舒张末期容积(LVEDV)、左室收缩末期容积 (LVESV)、每搏输出量 (LVSV)、左室射血分数 (LVEF)、心输出量 (CO)和心脏指数 (CI) ,评价心室室壁运动记分。术后 1～ 6个月内复查EBCT测定上述指标。为了更好地作手术前后的比较 ,将全组患者根据有无心肌梗死史和室壁运动情况分为 2组 :无心肌梗死史、心室造影证实室壁运动正常或仅中度以下减低为Ⅰ组 (14例 ) ,有心肌梗死史、室壁运动严重减低或更甚者为Ⅱ组 (8例 )。结果 Ⅰ组病例术后LVEDV、LVESV比术前明显减少 (P <0 .0 0 1) ,LVEF、CO、CI明显增加 (P <0 .0 1～ 0 .0 0 1)。Ⅱ组病例各项指标与手术前比较差异无显著性意义 (P >0 0 5 )。术前室壁运动中度下降的有 33个节段 ,术后有 2 8个节段 (84 .8% )恢复正常 ;严重下降有 15个节段 ,术后有 5个节段 (33.3% )有改善 ;无运动 10个节段 ,术后仅有 1个节段有改善 (10 % )。结论 EBCT能有效评价CABG效果 ,适用于冠心病患者术前检查及术后长期随访。
Objective To compare the changes of left cardiac function before and after coronary artery bypass grafting (CABG) by using EBCT and to evaluate CABG effect. Methods The preoperative values of LVEDV, LVESV, LVSV, LVEF, CO, CI, and left ventricular wall motion score were assessed by EBCT in 22 patients. The values were re-examined by EBCT in 1 to 6 months after CABG. According to the history of myocardial infarction and ventricular wall motion, 22 patients were divided into two groups. Group Ⅰ (14 cases) involved patients with no history of myocardial infarction and the ventricular motion was normal or moderate hypokinesia confirmed by X-ray left ventriculogram; Group Ⅱ (8 cases) included patients with history of myocardial infarction and the ventricular motion was in severe hypokinesia or even worse confirmed. Results After CABG, the values of LVEDV and LVESV were reduced (P<0.001) and LVEF, CO, and CI were increased significantly (P<0.01-0.001) compared with preoperation in group Ⅰ. On the contrary, there were no significant changes of these indexes (P>0.05) in group Ⅱ. There were 33 moderate hypokinesia segments preoperatively and 28 (84.8%) segments recovered normal postoperatively; 5 of 15 (33.3%) severe hypokinesia segments improved postoperatively; 1 of 10 (10%) akinesis segments improved postoperatively. Conclusions EBCT is useful in evaluating the effect of CABG by estimating the changes of cardiac function indexes. It is a non-invasive modality, valuable and suitable for long-term follow-up after CABG.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2003年第12期1147-1149,共3页
Chinese Journal of Radiology
基金
广东省科研攻关资助项目 ( 99M0 460 3G)
广东省卫生厅科研基金资助项目 (A2 0 0 0 172 )
