经食道超声心动图在瓣膜置换术中评价三尖瓣反流程度的应用  

The Application of Transesophageal Echocardiography in Evaluating the Severity of Tricuspid Regurgitation in Cardiac Valve Replacement

作　　者：侯庆[1] 王业兵[1] 罗孝勇[1] 邓萍[1] 何厚洪[1] 

机构地区：[1]遂宁市中心医院超声科,四川遂宁629000

出　　处：《现代医用影像学》2016年第3期466-468,共3页Modern Medical Imageology

摘　　要：目的:探讨应用经食道超声心动图在风湿性心脏病瓣膜置换术中即刻评价三尖瓣反流的程度并指导手术方案确定的临床价值。材料与方法:对我院72例风湿性心脏病患者进行术前三尖瓣损害程度及反流情况评估,术中应用经食道超声心动图即刻评估左心瓣膜置换术后三尖瓣反流情况,指导调整手术方案。主要根据三尖瓣反流束面积将其程度分为:轻度(反流束面积<4cm2)、中度(反流束面积4-8cm2)、重度(反流束面积>8cm2)。结果:22例轻度暂不予处理,43例成功行Kays成形术、De Vega成形术、Carpentier成形环,5例进行三尖瓣置换;术后随访三尖瓣反流程度较术前明显减轻,右心房未见明显扩大。结论:经食道超声心动图可在左心瓣膜置换术中即刻评估三尖瓣反流程度,对手术方案的确定有重要的临床应用价值,值得推广应用。Purpose： To discuss the clinical value of transesophageal echocardiography（ TEE） in evaluating the severities of tricuspid regurgitation（ TR） immediately and helping to verify the guide to operation in cardiac valve replacement of rheumatic heart disease（ RHD） patients. Materials and Methods： 72 patients with RHD of our hospital were studied on TR before operation. During operation,the severities of TR were evaluated by TEE immediately after left-side cardiac valve replacement,which guided the operation scheme. The severities of TR were divided into： mild regurgitation（ area 4cm2）,moderate（ area = 4-8cm2）,severe（ area 8cm2）. Results： 22 cases of mild regurgitation were not treated,43 cases of moderate regurgitation were treated by Kays valvuloplasty,De Vega valvuloplasty or Carpentier valvuloplasty,and 5 cases of severe regurgitation by tricuspid valve replacement. The severities of TR were decreased obviously in the postoperative followup compared with preoperative regurgitation,and right atrium were not enlarged significantly. Conclusion： The TEE has important clinical value for evaluating the severities of TR immediately and helping to guide the operation scheme in left-side cardiac valve replacement,which is worthy of spreading to application.

关 键 词：经食道超声心动图 心瓣膜置换术 三尖瓣反流 

分 类 号：R540.45[医药卫生—心血管疾病]