经食管实时三维超声心动图在心脏外科手术中的应用  

Clinical application of real-time three dimensional transesophageal echocardiography in operation

作　　者：陈欧迪[1] 王浩[1] 江勇[1] 段福建[1] 叶赞凯[1] 王志民[1] 王燕[1] 崔琪琼[1] 吕秀章[1] 李建蓉[1] 

机构地区：[1]中国医学科学院北京协和医学院心血管病研究所阜外心血管病医院超声科,100037

出　　处：《中华医学超声杂志（电子版）》2009年第2期20-23,共4页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：首都医学发展基金重点项目(20072020)

摘　　要：目的探讨经食管实时三维超声心动图在心脏外科手术中应用的可行性及价值。方法对接受心脏外科手术的24例患者进行经食管实时三维超声心动图术中监测,其中风湿性心脏病二尖瓣病变或二尖瓣主动脉瓣联合病变10例,二尖瓣脱垂2例,机械瓣置换术后机械瓣功能异常1例,主动脉瓣二瓣化畸形1例,室间隔缺损1例,房间隔缺损合并室间隔缺损1例,心内膜垫缺损2例,法洛四联症2例,大动脉转位合并室间隔缺损、房间隔缺损、左心室流出道狭窄1例,三尖瓣闭锁合并房间隔缺损、肺动脉狭窄1例,主动脉夹层2例。结果经食管实时三维超声心动图能够在术前清晰显示病变的三维结构,与术中所见基本一致,术后可即刻通过三维图像更直观评价手术效果。结论经食管实时三维超声心动图可方便应用于心脏术中监测,为心脏手术术前决策及术后效果评价提供重要信息,补充了常规术中超声应用的不足。Objective To investigate the feasibility and clinical application of intraoperative real time three dimensional transesophageal echocardiography （RT-3D-TEE）. Methods Twenty-four patients undergoing cardiac surgery were monitored by RT-3D-TEE in the operating room including 10 patients with rheumatic heart disease, 2 patients with mitral prolapse, 1 patient with dysfunctional mitral prosthetic valve, 1 patient with bicuspid arotic valve, 1 patient with ventricular septal defect, 1 patient with ventricular septal defect and a concomitant atrial septal defect, 2 patients with atrioventricualr septal defect, 2 patient with tetralogy of Fallot, 1 patient with transposition of the great arteries, 1 patient with tricuspid atresia and 2 patients with aortic dissection. Results The RT-3D-TEE was performed successfully in all the patients with good image quality. The preoperative RT-3D-TEE was consistent with intraoperative findings. The RT-3D- TEE displayed the cardiac lesions distinctly before the operation and had a capability of evaluating the surgery effect instantaneously. Conclusions The RT-3D-TEE is a reliable novel technique supplementary to traditional intraoperative transesophageal echocardiography, which is valuable in the decision-making before the operation and a powerful tool for the instantaneous evaluation of the surgery effect.

关 键 词：经食管超声心动描记术 三维超声心动描记术 心脏外科手术 手术中监测 

分 类 号：R654.2[医药卫生—外科学]