心外膜超声心动图在心脏手术中的应用价值  

Application Value of Intraoperative Epicardial Echocardiography in Cardiac Surgery

作　　者：田瑞霞[1] 史学功[2] 肖洁[2] 韩继彪[3] 张俊峰[3] 魏卓君 陈训[1] 

机构地区：[1]安徽医科大学解放军临床学院第105医院超声科 [2]安徽医科大学第一附属医院心内科 [3]安徽医科大学解放军临床学院第105医院心外科,合肥230031

出　　处：《中国胸心血管外科临床杂志》2016年第6期581-585,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的评估应用心外膜超声心动图（IEE）对术前监测及手术疗效的效果。方法回顾性分析2008年6月至2015年5月在安徽医科大学解放军第105医院和安徽医科大学第一附属医院心外科收治248例患者的临床资料,其中男108例、女140例,年龄7个月～71岁;其中先天性心脏病患者113例,瓣膜病患者135例,其中先天性心脏病患者平均年龄（11.89±14.74）岁,瓣膜病患者平均年龄（47.20±14.57）岁。应用IEE行术中超声监测。结果113例行先天性心脏病矫治术患者经IEE诊断,在体外循环前发现部分合并新的畸形,纠正了术前诊断,在体外循环复跳后及时发现手术并发症。135例行瓣膜成形和（或）置换术患者经IEE诊断,在体外循环前发现部分合并其他畸形或左房血栓;体外循环复跳后发现瓣周漏或大量反流,立即行再次心脏停跳处理。结论 IEE能完善术前诊断,有效降低围手术期并发症,在心脏外科手术中有重要的应用价值。Objective To investigate the effect of applying intraoperative epicardial echocardiography（IEE） on preoperative monitoring and evaluating the clinical result of cardiac surgery. Methods We retrospectively analyzed the clinical data of 248 patients treated in the Affiliated 105 Hospital of People＇s Liberation Army and the First Affiliated Hospital of Anhui Medical University from June 2008 to May 2015. There were 108 males and 140 females. The age ranged from 7 months to 71 years. There were 113 patients diagnosed with the congenital heart disease（CHD） at the mean age of 11.89±14.74 years. There were 135 patients diagnosed with valvular heart disease at the mean age of 47.20±14.57 years. All patients underwent IEE during operation. Results In 113 patients with CHD,we found new deformities and corrected preoperative diagnosis before cardiopulmonary bypass（CPB） and we identified surgical complications after CPB by IEE. Other deformities and left atrial thrombus were found in 135 patients with valvular heart disease by IEE before CPB. After CPB,paravalvular leak and mitral regurgitation were found,therefore we took action immediately. Conclusions IEE can improve the preoperative diagnosis and reduce perioperative complications,which has value of application during cardiac surgery.

关 键 词：先天性心脏病 心瓣膜病 超声心动图 经心外膜 心脏外科手术 

分 类 号：R654.2[医药卫生—外科学] R540.45[医药卫生—临床医学]