目的 探讨彩色多普勒超声心动图在肺动脉栓塞中的应用价值.方法 临床经CT肺动脉造影(CTPA)、核素肺动脉灌注扫描、肺动脉造影及部分手术证实肺动脉栓塞患者68例,行经胸彩色多普勒超声心动图检查及下肢深静脉彩色多普勒超声检查,观察右心及肺动脉及其分支血栓回声及右心结构和功能状况、三尖瓣反流程度及肺动脉压以及下肢深静脉有无血栓栓塞.结果 68例患者中超声心动图检出肺动脉内血栓直接征象9例,其余患者可见右心扩大、右室壁运动幅度明显减低、室间隔运动异常、肺动脉内径改变及下腔静脉呼吸变化率减小等相关间接征象改变.结论 超声心动图在诊断肺动脉栓塞中具有重要的临床意义,以提高其诊断的敏感性和特异性,在诊断肺栓塞溶栓治疗疗效观察中具有重要意义.%Objective To investigate the value of the color doppler echocardiography in pulmonary embolism. Methods 68 patients were confirmed with pulmonary embolism by clinical CT pulmonary angiography (CTPA),radionuclide pulmonary perfusion scanning,pulmonary artery angiography,and part of surgery through the chest of color doppler echocardiography,lower extremity deep vein of color doppler ultrasound examination,observation of right heart and pulmonary artery and its branches thrombus echo and the status of the right cardiac structure and function, degree of tricuspid regurgitation and pulmonary artery pressure and lower extremity deep venous thromboembolism were observed. Results 68 patients were detected with echocardiography in 9 cases of pulmonary artery thrombus within the direct signs and the rest of the patients could be seen right expansion,right ventricular wall motion amplitude obviously reduced and abnormal ventricular septal motion,changed in pulmonary artery diameter and inferior vena cava breathing rate reduced indirect signs related to changed. Conclusions Echocardiography has important clinical significance in the diagnosis of pulmonary embolism and can improve its diagnostic sensitivity and specifically,in the diagnosis of pulmonary embolism thrombolysis treatment curative effect observation is of great significance.
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