经食管超声心动图在术中评价二尖瓣置换术的应用价值  

作　　者：詹正民[1] 韦舒静[1] 吴文绪[1] 

机构地区：[1]广西医科大学附属第一人民医院,530022

出　　处：《中国农村卫生》2016年第04X期13-14,共2页

摘　　要：目的:分析经管道超声心动图在术中评价二尖瓣置换术中的应用价值。方法:选取我院2013年到2015年间收治的行二尖瓣置换手术的患者40例作为研究对象,所有患者均在术中辅以经食管超声心动图监测,观察患者的手术效果以及瓣周反流发生情况,并分别比较经食管超声心动图、经胸超声心动图判断瓣周反流发生的灵敏度、特异性、准确度。结果:40例实施二尖瓣置换术的患者中,38例一次手术成功,4例患者合并瓣周反流,2例程度轻微,2例中重度瓣周反流患者需要给予行瓣周漏修补术,占5.0%,比较经食管超声心动图、经胸超声心动图诊断瓣周反流的灵敏度、特异性以及总的准确度,可见经食管超声心动图所有结果显著高于经胸超声心动图,有统计学差异(P<0.05)结论:采用实时经食管超声心动图检查可以对为医生提供病变住置及其周围结构的更加可靠信息,有利于手术的顺利进行和瓣周反流的及时发现,降低二次开胸率,值得临床推广应用。Objective： to analyze the application value of intro--operative transesophageal echocardiographic in evaluation of mitral valve replacement. Methods： 40 patients in our hospital from 2013 to 2015 who were underwent mitral valve replacement surgery were selected as the object of study. All patients were performed intro--operative transesopbageal echoeardiography to observe effect of operation and paravalvular reflux status. Sensitivity, specificity, and accuracy of detecting paravalvular reflux of transesophageal echocar-dlography and transthoracic echocardiography echocardiography were compared. Results： In 40 cases of patients with the mitral valve replacement, 38 cases had a successful operation, in which 2 patients were with mild paravalvular regurgitation. Moderate to severe paravalvular regurgitation happened in 2 cases, who need to be given for paravalvular leakage repair, accounted for 5 %. Sensitivity, specificity, and accuracy of detecting paravalvular reflux of transesophageal echocardiography and transthoracie echocardiography echocar-diography were compared, and all results of transesophageaI echocardiography were significantly higher than that of transthoracie echocardiography. There was significant difference （P〈 0.05） conclusion; Real--time transesophageal echocardiography can provided more reliable information for the location of the lesion and its surrounding structure for the surgeon. It is conducive to the successful operation and detecting paravalvular regurgitation in time, to reduce secondary thoracotomy rate. Clinical application is suggested.

关 键 词：经管道超声心动图 二尖瓣置换术 应用价值 

分 类 号：R540.45[医药卫生—心血管疾病] R654.2[医药卫生—内科学]