经食管超声心动图在左心耳封堵术后残余分流随访中的应用价值  

Application value of transesophageal echocardiography in the follow-up of residual shunt after left auricular occlusion

作　　者：吴春霞[1] 谌勉 余正春[1] 董利[1] 马小静[1] WU Chunxia;CHEN Mian;YU Zhengchun;DONG Li;MA Xiaojing(Center of Ultrasound,Wuhan Asia Heart Hospital,Wuhan 430022,China)

机构地区：[1]武汉亚洲心脏病医院超声中心,武汉市430022

出　　处：《临床超声医学杂志》2019年第4期272-274,共3页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨经食管超声心动图(TEE)在经皮左心耳封堵术后随访中的应用价值。方法选取在我院成功实施左心耳封堵术的54例心房颤动患者,术前应用TEE分别于0°、45°、90°、135°切面测量左心耳的最大开口径和最大深度;术后即刻及45 d随访观察封堵器形态和位置,测量封堵器腰部直径,计算压缩比,观察术中和术后是否出现残余分流。结果①54例患者中,左心耳最大开口径12～20mm10例,21～25 mm 30例,26～30 mm 13例,31～34 mm 1例,不同最大开口径出现残余分流的比例差异比较无统计学意义(P=0.332);②28例患者术中及术后45 d均未出现残余分流;16例患者术中出现残余分流(分流束<5 mm),术后45 d复查残余分流仍存在(分流束<5 mm);10例患者术中未出现残余分流,术后45 d复查出现残余分流(分流束<5 mm);③TEE于0°、45°、90°、135°切面上检出残余分流的比例分别为15.0%、17.5%、32.5%、35.0%;有残余分流患者与无残余分流患者间封堵器最大压缩比及最小压缩比比较差异均无统计学意义。结论 TEE在左心耳封堵术后随访中有重要临床应用价值。Objective To investigate the application value of transesophageal echocardiography(TEE)in the followup of residual shunt after percutaneous left auricular occlusion. Methods Fifty-four patients with atrial fibrillation were successfully treated left atrial appendage occlusion were selected. The maximum opening and maximum depth of left atrial appendage were measured by TEE on 0°,45°,90° and 135° sections before operation. The shape and position of occluder were observed immediately and 45 d after operation. The diameter of the occluder was measured and the compression ratio was calculated.The residual shunt was observed during and after operation. Results ①In 54 patients, the left atrial appendage had a maximum opening diameter of 12~20 mm in 10 cases, 21~25 mm in 30 cases, 26~30 mm in 13 cases, and 31~34 mm in 1 case. There was no significant difference in the proportion of residual shunt among the different maximum opening diameters(P=0.332).②No residual shunt occurred in 28 patients during and 45 d after operation,16 patients had residual shunt during operation(split beam <5 mm), and residual shunt still existed 45 d after surgery(split beam <5 mm). There were no residual shunts during the operation, and residual shunt occurred after 45 d of operation(split beam <5 mm).③The proportion of residual shunt detected by TEE on 0°, 45°, 90°, and 135° sections were 15.0%, 17.5%, 32.5%, and 35.0%, respectively. There were no statistically significant difference of maximum and minimum compression ratio between patients with residual shunt and patients without residual shunt. Conclusion TEE plays an important role in the follow-up of left atrial appendage occlusion.

关 键 词：超声心动描记术 经食管 心房颤动 左心耳封堵术 残余分流 

分 类 号：R540.45[医药卫生—心血管疾病] R541[医药卫生—内科学]