刘香碧

[摘要] 目的 探讨经胸超声心动图常规胸骨上窝切面检查对主动脉弓部疾病诊断的临床价值。方法 方便选取在广西医科大学附属医院进修期间（2017年7—8月）做经胸超声心动图检查的患者1 892例，常规行胸骨上窝切面扫查，显示主动脉弓部长轴及短轴切面，观察主动脉弓部走形、测量内径及血流情况，观察异常类型及程度。 结果 主动脉弓显示率达95.8%，只有8例患者因气胸或肺气影响显示不清，检出存在主动脉弓疾病的病例共49例，其中主动脉弓部缩窄26例，主动脉弓离断2例，右位主动脉弓8例，主动脉弓部扩张4例，主动脉弓部夹层伴血栓1例，检出主动脉弓部缩窄病例最多，以上病例均经其他影像检查证实，主动脉弓病变与超声心动图检查结果基本一致。结论 经胸超声心动图常规行胸骨上窝切面检查对主动脉弓疾病诊断有重要的临床价值，检查方便快捷，对主动脉弓疾病诊断符合率高，建议经胸超声心动图常规行胸骨上窝切面检查，增加主动脉弓疾病的检出率。

[关键词] 超声心动图；主动脉弓；主动脉缩窄

[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2018）06（c）-0177-03

[Abstract] Objective This paper tries to explore the clinical value of transthoracic echocardiography in the diagnosis of aortic arch disease. Methods A total of 1 892 patients who underwent transthoracic echocardiography during the study period at the Affiliated Hospital of Guangxi Medical University （from July to August 2017） were selected conveniently and routinely performed an upper sternal scan to show the long axis and short axis of the aortic arch and observe the aortic arch， measure the internal diameter and blood flow， observe the abnormal type and degree. Results The aortic arch showed a rate of 95.8%. Only 8 patients showed unclear effects due to pneumothorax or pulmonary airway. A total of 49 cases with aortic arch disease were detected， including 26 cases of aortic arch constriction， 2 cases of aortic arch dissection， and 8 cases of right aortic arch. For example， there were 4 cases of aortic arch dilatation， 1 case of aortic arch dissection with thrombus， and the most cases of aortic arch narrowing were detected. The above cases were confirmed by other imaging examinations， and the aortic arch disease was basically consistent with the results of echocardiography. Conclusion Transthoracic echocardiography routinely performed on the upper sternal fossa examination has important clinical value in diagnosing aortic arch diseases. The examination is convenient and quick. The diagnostic accuracy of aortic arch disease is high. It is recommended that transthoracic echocardiography be performed routinely to check the upper sternal fossa and increase the detection rate of aortic arch disease.

[Key words] Echocardiography； Aortic arch； Coarctation of the aorta

主動脉弓部疾病主要有主动脉弓部缩窄、主动脉弓离断、右位主动脉弓、主动脉弓部瘤、主动脉弓部夹层动脉瘤等。主动脉弓缩窄及离断都会不同程度影响躯干及下肢供血，影响小儿身体发育，多伴有高血压，严重的可能心衰死亡。主动脉弓部瘤及主动脉夹层破裂可能危及患者生命，早期发现主动脉弓部异常对于患者后期生存及生活质量有重要意义。……