超声心动图引导经胸小切口室间隔缺损封堵术  

Echo-cardiography-guided occlusion of ventricular septal defect via small chest incision

作　　者：吴勤[1] 高雷[1] 杨一峰[2] 赵天力[2] 王欣[2] 尹倪[2] 徐新华[1] 

机构地区：[1]中南大学湘雅二医院胸心外科心脏超声专科,长沙410011 [2]中南大学湘雅二医院胸心外科小儿心脏外科,长沙410011

出　　处：《中南大学学报（医学版）》2012年第7期699-705,共7页Journal of Central South University ：Medical Science

摘　　要：目的:探讨超声心动图在经胸小切口微创室间隔缺损封堵术前、术中、术后的全方位应用价值。方法:经胸小切口微创封堵术实施室间隔缺损患儿446例,术前行经胸超声心动图多切面评估室间隔缺损大小、位置、类型及与周围组织毗邻情况;术中行经食管超声心动图再次复核评估,确定封堵器型号,引导封堵器正确放置,评判封堵效果;术后行经胸超声心动图对封堵成功患儿定期随访。结果:446例室间隔缺损患儿中412例成功封堵,成功率92.4%。1年内定期随访,封堵器回声清晰,位置正常,无中量以上残余分流和瓣膜反流。结论:超声心动图(经胸及经食管)对经胸小切口室间隔缺损微创封堵术前病例筛选、术中封堵过程监测引导及术后疗效评估作用重要且相对可靠。Objective： To elucidate the preoperative, intraoperative, and postoperative utility of echo- cardiographic technology in occlusion ofventricular septal defect （VSD） via small chest incision. Methods： We performed occlusion of VSD via small chest incision in 446 children. Before surgery, a multiple-section transthoracic echo-cardiogram （qTE） was employed to evaluate various parameters （including the size, position, and type） of the VSD region as well as the condition of neighboring tissues. During surgery we reassured the size of the occluder, meanwhile, guiding placement of the occluder by transesophageal echocardiogram （TEE）. Patients also received postoperative follow-ups at regular intervals. Results： Out of the 446 VSD cases, the defects of 412 patients were successfully closed; a 92.4% successful rate. All patients received follow-ups one year aAer operation. The occluders had firmly and echoed clearly. No notable residual shunt or valve regurgitation was discovered. stayed Conclusion： During occlusion of VSD via small chest incision, echo-cardiogram technology （including TEE and TEE） can play a vital role by helping screen cases preoperativel）3 by guiding the closure intraoperatively, and by evaluating therapeutic efficacy postoperatively, providing relatively accurate and accountable results at all stages.

关 键 词：室间隔缺损 经胸小切口封堵术 超声心动图 室间隔封堵器 

分 类 号：R445.1[医药卫生—影像医学与核医学] R726.5[医药卫生—诊断学]