摘要
目的利用四维自动右心室定量分析技术(4D Auto RV)评价肺切除术后患者的早期右心室容积和功能变化情况。方法选取2021年1月~2022年12月在中国科学技术大学附属第一医院行胸腔镜下肺结节肺切除术的患者51例,其中单纯肺段或肺楔形切除25例,肺叶切除26例。在进行肺切除的术前和术后1月内行超声心动图检查,利用4D Auto RV技术评估肺切除术后右心室容积和功能的变化,右心室容积参数包括右室舒张末期容积(EDV)、右室收缩末期容积(ESV)、每搏输出量等。右心室功能参数包括右心室射血分数(RVEF)、三尖瓣环纵向位移(TAPSE)、面积变化分数(FAC)及右心室整体纵向应变(RV-GPLS)、游离壁侧纵向应变(RV-FWPLS)。结果胸腔镜下肺切除术后早期右心室容积增加,具体表现为手术前后的EDV、ESV发生变化(P<0.05),每搏输出量在手术前后的变化无统计学意义(P>0.05)。右心室功能参数FAC、RV-GPLS、RV-FWPLS在手术前后的差异有统计学意义(P<0.05),其对手术引起的右心室功能改变较敏感,而RVEF和TAPSE在手术前后的变化差异无统计学意义(P>0.05)。单纯肺段/楔形切除术与肺叶切除术两种手术切除范围对患者术后右心容积和功能参数变化差异无统计学意义(P>0.05)。结论肺切除术后早期阶段,尽管患者可能未表现出明显的临床症状,但通过4D Auto RV技术发现术后右心室扩张,早期出现右心室轻度功能障碍,表现为FAC、RV-GPLS和RV-FWPLS减低。
Objective To employ the advanced four-dimensional automated right ventricular quantification(4D Auto RV)technique as a tool for evaluating the early postoperative alterations in RV volume and function among patients who have undergone lung resection surgery.Methods A total of 51 patients who underwent thoracoscopic lung resection for pulmonary nodules in the First Affiliated Hospital of University of Science and Technology of China from January 2021 to December 2022 were selected,including 25 patients with simple segmental or wedge resection and 26 patients with lobectomy.Echocardiography was performed before and within 1 month after lung resection,and the change a in right ventricular volume and function after lung resection were assessed using the 4D Auto RV technique.Right ventricular volume parameters included end-diastolic volume(EDV),end-systolic volume(ESV),and stroke volume(SV).Right ventricular function parameters included right ventricular ejection fraction(RVEF),tricuspid annular plane systolic excursion(TAPSE),fractional area change(FAC),and right ventricular longitudinal strain values[global longitudinal strain(RV-GPLS),free wall longitudinal strain(RV-FWPLS)].Results Following early stages post-thoracoscopic lung resection,there was a significant increase in right ventricular volume,manifesting as statistically significant changes in both EDV and ESV before and after surgery(P<0.05).However,the change in stroke volume pre-and post-surgery did not reach statistical significance(P>0.05).Upon further analysis of right ventricular functional parameters,there were significant statistical changes in FAC,RV-GPLS,and RV-FWPLS before and after surgery(P<0.05),indicating that these parameters were more sensitive to the alterations in right ventricular function induced by the surgery.The changes in RVEF and TAPSE did not achieve statistical significance preand post-surgery(P>0.05).The differences in post-operative right ventricular volume and functional parameter changes between patients undergoing either limited resection such as segmentectomy/wedge resection versus lobectomy were not statistically significant(P>0.05).Conclusion In the phase following lung resection,despite the possible absence of overt clinical symptoms,the utilization of 4D Auto RV technology has revealed a phenomenon of right ventricular dilation,indicative of early onset of mild right ventricular dysfunction.This dysfunction manifests as decrements in FAC,RV-GPLS and RV-FWPLS.
作者
刘红娇
李卫虹
杨冬妹
LIU Hongjiao;LI Weihong;YANG Dongmei(Department of Echocardiography,The First Affiliated Hospital of the University of Science and Technology of China,Hefei 230002,China)
出处
《分子影像学杂志》
2024年第10期1113-1118,共6页
Journal of Molecular Imaging
关键词
超声心动图新技术
肺切除术
右心室功能
斑点追踪
new technology of echocardiography
lung resection
right ventricular function
speckle tracking
作者简介
刘红娇,硕士,住院医师,E-mail:hongjiaoliu@126.com;通信作者:杨冬妹,硕士,主任医师,E-mail:dmymail627@126.com。
