下腔静脉声象图与M型显示的临床应用

本文报告下腔静脉声象图及M型显示,正常下腔静脉M型显示与颈静脉搏动图类似,有“a”波与“v”波,显示显著的周期性呼吸性变化。右心衰竭、三尖瓣返流和缩窄性心包炎时下腔静脉常扩张,呼吸性凹陷变浅或消失。各类心律失常时下腔静脉各有特征性改变;例如,房颤、房扑时,“a”波消失,完全性房室传导阻滞时,“a”波呈“大炮波”,慢性肺心病患者,“a”波加深但时限短促。我们在右室容量负荷过重和各种渗出性心包炎患者中未发现该声象图有何异常。上述结果表明“a”波反映了右心房的收缩。腹部和腹膜后疾病常涉及下腔静脉。根据下腔静脉的行径,对推断邻近包块的起源很有帮助。

CLINICAL APPLICATION OF INFERIOR VENA CAVA ECHOCARDIOGRAPHY

The article reports the echocardiographic manifestations of the inferior vena cava (IVC). The normal IVC M-mode echocardiogram appeared which has "a" and "V" waves similar to the jugular venous tracting and exhibits Prominent periodic respiratory changes. In right heart failure, tricuspid regurgitation and constrictive pericarditis, the IVC was usually distended with diminished or absented respiratory coUapse. The specific patterns of the M-mode IVC tracting could be observed during various dysrhythmias. For instance, the "a" wave disaPeared in atrial fibrillation and atrial flutter or showed "common "a" waves from patients with complete heart block, while in chronic cor-pulmonale the "a" wave was increased but the period was short. There were not any changes in an overloaded right ventricular volume and various pericarditis with effusion. The results indicate that the "a" wave reflects the right atrium contraction. The IVC is frequently involved by abdominal and retroperitoneal diseases. Thus, it is greatly helpful to evaluate the course of IVC in determining the origin of an adjacent mass.