2种围检期方法在对比增强经颅多普勒超声筛查卵圆孔未闭中的效果比较OA
Effects comparison of two peri-examination methods in contrast-enhanced transcranial Doppler screening for patent foramen ovale
目的 探讨对比增强经颅多普勒超声(cTCD)筛查/评价卵圆孔未闭围检期中不同宣教、检查方式对检查结果的影响.方法 回顾性选取2023年5月至2024年2月在我院进行cTCD筛查/评价卵圆孔未闭的患者为研究对象.根据围检期不同处置方法将患者分为观察组和对照组,将采用视频宣教、改良Valsalva动作、20 mL注射器推注对比剂的患者纳入观察组,而采用人工宣教、Valsalva动作、10 mL注射器推注对比剂的患者纳入对照组,对比分析2组患者卵圆孔未闭的阳性检出率、Valsalva/改良Valsalva动作下的微泡右向左分流分级、收缩期血流速度、搏动指数(PI)、阻抗指数(RI)、检查用时、围检期医患沟通总用时、封堵率、患者满意度等.结果 对照组和观察组患者卵圆孔未闭cTCD阳性检出率(82.93%vs.95.92%)、最大量微泡(Ⅲ级)检出率(39.02%vs.61.22%)、围检期医患沟通总用时[11.30(10.00,14.00)min vs.8.23(7.00,10.00)min]、卵圆孔未闭封堵率(48.78%vs.73.47%)、患者总满意度(80.49%vs.91.84%)等比较,差异均有统计学意义(P<0.05);受试者工作特征(ROC)曲线分析显示,对照组和观察组检查方法诊断卵圆孔未闭的曲线下面积(AUC)分别为0.718、0.855.结论 采用视频宣教、改良Valsalva动作、20 mL注射器推注对比剂等围检期干预方式可提高卵圆孔未闭的阳性检出率,还能减少医患之间的无效沟通,提高患者满意度.
Objective To explore the effects of different education and examination methods on the examination results during the screening/evaluation of patent foramen ovale by contrast-enhanced transcranial Doppler(cTCD).Methods Patients who underwent cTCD screening/evaluation for patent foramen ovale in our hospital from May 2023 to February 2024 were retrospectively selected as the research subjects.The patients were divided into the observation group and the control group according to different education and examination methods during the peri-examination period.Patients who received video education,modified Valsalva maneuver,and injection of contrast agent with 20 mL syringe were included into the observation group,and patients who received artificial education,Valsalva maneuver,and injection of contrast agent with 10 mL syringe were included into the control group.The positive detection rate of patent foramen ovale,right-to-left shunt microbubble grading during Valsalva/modified Valsalva maneuver,systolic blood flow velocity,pulsatility index(PI),resistive index(RI),examination duration,total physician-patient communication time,whether occlusion surgery was performed,and patient satisfaction were compared between the two groups.Results The positive detection rate of patent foramen ovale by cTCD(82.93%vs.95.92%),the detection rate of the maximum amout(grade Ⅲ)of microbubbles(39.02%vs.61.22%),the total physician-patient communication time during the peri-examination period[11.30(10.00,14.00)minutes vs.8.23(7.00,10.00)minutes],the rate of occlusion surgery(48.78%vs.73.47%),and the total patient satisfaction(80.49%vs.91.84%)showed statistically significant differences between the control group and the observation group(P<0.05).Additionally,the receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)for diagnosing patent foramen ovale were 0.718 in the control group and 0.855 in the observation group.Conclusion Peri-examination interventions such as video education,modified Valsalva maneuver,and injection of contrast agent with 20 mL syringe can improve the positive detection rate of patent foramen ovale,reduce ineffective physician-patient communication,and improve patient satisfaction.
徐永美;汪萃;李华康;张丰;谭琳;张雪;万陈;许详;胡俊
陆军军医大学第一附属医院神经内科,重庆 400038陆军军医大学第一附属医院神经内科,重庆 400038陆军军医大学第一附属医院心血管内科,重庆 400038陆军军医大学第一附属医院超声科,重庆 400038陆军军医大学第一附属医院神经内科,重庆 400038陆军军医大学第一附属医院神经内科,重庆 400038陆军军医大学第一附属医院心血管内科,重庆 400038陆军军医大学第一附属医院心血管内科,重庆 400038陆军军医大学第一附属医院神经内科,重庆 400038
医药卫生
卵圆孔未闭对比增强经颅多普勒超声阳性检出率假阴性率改良Valsalva动作
patent foramen ovalecontrast-enhanced transcranial Dopplerpositive detection ratefalse-negative ratemodified Valsalva maneuver
《局解手术学杂志》 2025 (9)
784-788,5
国家自然科学基金面上项目(81873755)重庆市自然科学基金创新发展联合基金重点项目(CSTB2023NSCQ-LZX0139)
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