超声心动图在小儿先天性心脏病手术中的应用研究  

Intraoperative Echocardiography in Pediatric Congenital Heart Surgery

作　　者：李永青[1] 罗毅[1] 张桂珍[1] 欧阳川[2] 耿斌[1] 

机构地区：[1]首都医科大学附属北京安贞医院小儿心脏科,北京市100029 [2]首都医科大学附属北京安贞医院麻醉科,北京市100029

出　　处：《中国超声医学杂志》2005年第4期274-276,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的　探讨超声心动图技术在小儿先天性心脏病手术中的应用。方法　在4 2例小儿先天性心脏病手术中,于心内结构修复完成后行超声检查,其中经食管超声心动图( TEE) 3 4例,经心外膜超声心动图( EE) 8例。结果　根据超声检查结果,3例患儿因中-重度二尖瓣返流、1例因房水平残余分流、1例因肺动脉瓣下狭窄,重新转机修复心内结构;1例因左室后下壁心肌缺血,再次转机辅助循环。所有患儿术后无超声检查相关并发症发生。结论　TEE与EE结合应用于小儿先天性心脏病手术中,有重要的应用价值,且具有安全。Objective To report our experience in intraoperative echocardiography (IOE) in pediatric congenital heart surgery and to assess its clinical value.Methods Epicardial echocardiography (EE) was used in children less than 5 kg and in circumstances that IOE was needed unexpectedly.Biplane pediatric transesophageal probe was used for children from 5 to 15 kg and adult size multiplane probe for those over 15 kg.TEE probe was inserted after endotracheal intubation and IOE was performed immediately after cardiopulmonary bypass.IOE was performed in 42 children undergoing corrective or palliative surgery for congenital heart disease from January 2001 to July 2004.EE was performed in 8 children,biplane TEE in 19,and multiplane TEE in 15.Age ranged from 7 days to 15 years,and body weight ranged from 4 to 37 kg.Results IOE findings prompted a return to cardiopulmonary bypass for further surgery or circulation support in six children (14.3%),3 of whom were due to moderate to severe mitral regurgitation,1 dve to residual shunt,1 due to severe subvalvular pulmonary stenosis and 1 due to myocardial ischemia.We also observed some suboptimal but acceptable surgical outcome.No respiratory compromise,obvious hemodynamic changes or other diverse effects were observed.Conclusions Intraoperative TEE and EE play a vital role in children undergoing congenital heart surgery.They are also safe and cost-effective.

关 键 词：小儿先天性心脏病 手术中 经心外膜超声心动图 经食管超声心动图 超声心动图技术 超声检查结果 下壁心肌缺血 心内结构 二尖瓣返流 相关并发症 残余分流 瓣下狭窄 辅助循环 结合应用 应用价值 肺动脉 TEE 修复 患儿 

分 类 号：R445.1[医药卫生—影像医学与核医学]