特发性脊柱侧凸患者术前超声心动图筛查结果分析

目的研究需手术治疗的特发性脊柱侧凸(IS)患者心脏异常发生率,并探讨其影响因素。方法回顾性分析245例住院治疗的特发性脊柱侧凸患者的临床资料和超声心动图结果,并按心脏结构性异常和心脏功能性异常分类,分别统计其发生率。按患者的性别、年龄、冠状面主弯Cobb角分组,分析上述因素对心脏异常发生率的影响。并对比心脏异常和心脏正常患者的年龄、主弯角度及超声心动图各指标是否有统计学差异。结果纳入研究的IS患者共245人,共有106人心脏出现异常,包括28人心脏结构性异常和78人心脏功能性异常。在心脏结构性异常中房间隔缺损最多见(11人,11/28;39.29%),而在心脏功能性异常中三尖瓣微量返流最多见(63人,63/78;80.77%)。按性别、年龄、冠状面主弯Cobb角分组后,分别比较心脏异常发生率、心脏结构性异常发生率及心脏功能性异常发生率均无统计学意义(P≥0.05)。按心脏异常和心脏正常分组,对比两组患者间年龄、主弯角度及心脏各腔内径与左室收缩功能,除左房内径(t=2.35,P=0.02<0.05)外,其他测值均无显著差异。结论需手术治疗的特发性脊柱侧凸患者中有相当比例的患者存在心脏结构性或功能性异常。完善术前超声心动图检查,有助于了解患者心功能状态,为围手术期安全提供参考。

Findings of echocardiography for preoperative evaluation in idiopathic scoliosis

Objective To study the incidence of cardiac abnormalities in idiopathic scoliosis patients, who need surgical correction in Southwest of China, and to clarify influence factors on the incidences. Methods Firstly, retrospective analyze all the clinical data and eehocardiographic results of inpatients with idiopathic scoliosis in West China Hospital from January 2007 to October 2011. To study the incidences of cardiac abnormalities, including incidences of cardiac structure abnormalities and functional abnormalities. Secondly, to analyze the influences of patient＇s gender,age and degree of the main curve Cobb angle at the coronal plane on the incidence of cardiac abnormalities using statistical methods. Finally, use Student＇s t test to compare the age, the degree of main curve Cobb angle and each index of echocardiography between cardiac anomalies and noncardiae anomalies. Results 245 patients participated in this study. In which, there were one hundred and six patients with cardiac abnormality, dividing into twenty eight cardiac structure anomaly and seventy eight cardiac functional anomaly. The most common structure anomaly was atrial septal defect （11, 39.29%）, while the most common functional anomaly was mild tricuspid regurgitation （63, 80. 77%）. There had no significant differences in the incidences of cardiac anomaly, cardiac structure anomaly and cardiac functional anomaly based on gender, age and degree of the main Cobb angle differenee（P≥0.05）. The only different eehocardiographie measured value was the diameter of left atrium （t=2.35,P=0.02〈0. 05） between cardiac anomaly group and noncardiac anomaly group, the rest measured values had no significant differences. Conclusion A significant proportion of patients, who need surgical correction for their idiopathic scoliosis, have cardiac structure anomaly or cardiac functional anomaly. Completing the preoperative echocardiography examination can help doctors understand the state of patients＇ cardiac function and offer some references to perioperative safety.