经食管超声心动图在房间隔缺损封堵术中的应用价值  

Application of transesophageal echocardiography in transcatheter occlusion for atrial septal defect

作　　者：温瑜鹏[1] 刘彦君[1] 任群[1] 崔海峡[1] 和俊平 WEN Yupeng;LIU Yanjun;REN Qun;CUI Haixia;HE Junping(Department of Ultrasound,Sanmenxia Central Hospital,Sanmenxia 472000,China)

机构地区：[1]三门峡市中心医院超声科,河南三门峡472000

出　　处：《中华实用诊断与治疗杂志》2018年第11期1118-1120,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：三门峡市科技计划项目(2013060305)

摘　　要：目的探讨房间隔缺损(atrial septal defect,ASD)封堵术中应用经食管超声心动图(transesophageal echocardiography,TEE)的临床价值。方法继发孔型ASD患者42例,均行TEE引导下ASD封堵术,并于术前、术后24h及出院前行经胸超声心动图(transthoracic echocardiography,TTE)检查。比较术前TEE及TTE测量的ASD最大径及残缘长度;Pearson相关分析TEE及TTE测量的术前ASD最大径与术中使用封堵器直径的相关性;TEE术后即刻、TTE术后24h及出院前评价封堵效果。结果 42例均封堵成功,封堵器直径为(21.54±6.82)mm;TEE测量的术前ASD最大径[(18.56±5.27)mm]、上缘长度[(11.69±3.84)mm]大于TTE[(16.27±4.93)、(10.14±2.76)mm],下缘长度[(10.43±3.72)mm]小于TTE[(12.28±4.04)mm](P<0.05),前下缘长度[(12.14±3.77)mm]、后上缘长度[(11.57±3.43)mm]、前缘长度[(4.64±1.24)mm]、后缘长度[(7.34±2.54)mm]与TTE[(12.37±3.86)、(11.68±3.85)、(4.57±1.39)、(7.48±2.36)mm]比较差异均无统计学意义(P>0.05);Pearson相关分析结果显示,术前TEE、TTE测量ASD最大径与术中使用封堵器直径均呈高度正相关(r=0.954,P<0.001;r=0.912,P<0.001);术后即刻TEE显示封堵器位置正常,塑形良好,房室瓣运动正常,心房水平分流消失,无并发症发生;术后24h及出院前复查TTE患者情况良好。结论继发孔型ASD患者采用TEE引导下介入封堵术治疗效果良好。Objective To investigate the clinical application of transesophageal echocardiography（TEE）in transcatheter occlusion for atrial septal defect（ASD）.Methods Forty-two patients with secundum ASD underwent transcatheter occlusion under TEE,and transthoracic echocardiography（TTE）was performed before operation,in 24 hafter operation and before discharge.The maximum diameter and residual length of ASD measured by TEE and TTE were compared before operation.The correlation of the maximum diameter of ASD measured by TEE and TTE before operation with the diameter of occluder was analyzed by Pearson correlation analysis.The occlusion results were evaluated immediately after operation by TEE,as well as in 24 hafter occlusion and before discharge by TTE.Results The operation was performed successfully in 42 patients,with the occluder diameter of（21.54±6.82）mm.The maximum diameter and upper margin length of ASD measured by TEE（（18.56±5.27）,（11.69±3.84）mm）were significantly longer than those by TTE（（16.27±4.93）,（10.14±2.76）mm）,the lower margin length was significantly shorter by TEE（（10.43±3.72）mm）than that by TTE（（12.28±4.04）mm）（P<0.05）,and there were no significant differences in the length of anterior lower margin（（12.14±3.77）mmvs（12.37±3.86）mm）,posterior upper margin（（11.57±3.43）mmvs（11.68±3.85）mm）,anterior margin（（4.64±1.24）mmvs（4.57±1.39）mm）and posterior margin（（7.34±2.54）mmvs（7.48±2.36）mm）by TEE and TTE（P>0.05）.Pearson correlation analysis showed that the maximum diameter of ASD measured by TEE and TTE before operation was positively correlated with the diameter of occluder（r=0.954,P<0.001;r=0.912,P<0.001）.TEE immediately after occlusion showed normal position of occluder,good shape,normal movement of the atrioventricular valve,disappearance of atrial horizontal shunt and no complications.TTE in 24 hafter occlusion and before discharge showed good recovery.Conclusion TEE guided transcatheter o

关 键 词：房间隔缺损 经食管超声心动图 经胸超声心动图 介入封堵术 

分 类 号：R654.2[医药卫生—外科学]