中文摘要：

目的：应用经胸超声心动图评价室间隔缺损（VSD）封堵术后心脏结构、功能和血流动力学的变化,以评估疗效和术后恢复情况。方法：38例成功施行经皮穿刺VSD封堵术的患者术前、术后1周、1月及1年分别进行超声心动图检查,常规测量左心房内径（LAD）、左心室舒张末及收缩末内径（LVDd,LVDs）、左室射血分数（LVEF）、左室流出道血流速度（VLOVT）、二尖瓣口舒张期血流峰值速度（Em,Am）;组织多普勒成像测量心室壁收缩期最大位移（Ds）、收缩期峰值速度（Vs）及二尖瓣环舒张早期及舒张晚期峰值速度（E’,A’）,并计算E’/A’、Em/E’。结果：VSD封堵术后早期,LAD、LVDd、Ds较术前明显缩小,VLOVT明显加快（P均〈0.05）,而LVEF、Vs无明显统计学差异（P〉0.05）,受损升高的左心室舒张功能指标Em/E’有所下降,但尚无统计学意义（P〉0.05）;术后1年,Em/E’下降至正常水平,VLOVT下降至术前水平（P均〈0.05）,结论：经皮穿刺VSD封堵术早期可纠正VSD患者左心容量负荷过重导致的血流动力学紊乱和心脏结构异常;中期可改善受损的左室舒张功能;超声心动图对VSD封堵前后心脏功能变化的评估起了重要的作用。

英文摘要：

Objective：To evaluate the treatment effect and recovering situation by indexes of cardiac structure,function and hemodynamics before and after ventricular septal defect occlusion using transthoracic echocardiography.Methods：Transthoracic echocar diography was performed in 38 patients with ventricular septal defect occlusion.Left atrial diameter（LAD）,left ventricular end-diastolic and end-systolic diameter（LVDd/LVDs）,left ventricular ejection fraction（LVEF）,systolic peak flow velocity over left ventricular outflow tract（VLOVT）and diastolic peak velocity over mitral valve flow（Em/Am）were measured by conventional methods.Tissue doppler imaging on left ventricular wall was detected and peak systolic displacement（Ds）,systolic peak velocity（Vs）were measured.Early diastolic peak velocity（E＇）,late diastolic peak velocity（A＇）over mitral annulus and E＇ over A＇ ratio,Em over E＇ ratio were calculated.Results：Early after transcatheter closure,LAD,LVDd and Ds were significantly reduced while VLOVT was increased obviously（P all0.05）.However,there was no significant difference in LVEF and Vs（P0.05）.Em/E＇ was also lower than that before the operation,but no significant difference.One year after occlusion,Em/E＇returned to normal level from a high level,and the elevated VLOVT went back to the level before operation.Conclusion：In the early time after transcatheter closure,the patients＇ cardiac structure and hemodynamics abnormalities which are caused by the left ventricular volume overload can be corrected.And in the inter-mediate stage after closure,the impaired left ventricular diastolic function can be improved.Echocardiography plays an important role in the evaluation of cardiac function before and after transcatheter closure.