术中经食管超声心动图在二尖瓣成形术中的应用  

Application of intraoperative transesophageal echocardiography in mitral valvuloplasty

作　　者：苏春晓[1] 吴棘[1] 陈辉[1] 蒋春兰[1] 曾德才 谢晓勇[2] 黄柳柳[2] Su Chunxiao;Wu Ji;Chen Hui;Jiang Chunlan;Zeng Decai;Xie Xiaoyong;Huang Liuliu(Ultrasonography Lab;Cardiovascular Surgery,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学第一附属医院超声科,南宁530021 [2]广西医科大学第一附属医院心血管外科,南宁530021

出　　处：《广西医科大学学报》2020年第6期1135-1138,共4页Journal of Guangxi Medical University

基　　金：广西自然科学基金资助项目(No.2017GXNSFAA198246);广西医疗卫生适宜技术开发与推广应用资助项目(No.S2017019);广西医学高层次骨干人才“139”计划资助项目(No.G201903014)。

摘　　要：目的:探讨术中经食管超声心动图(TEE)在二尖瓣成形中的应用价值。方法:对96例拟行二尖瓣成形术的患者予术前TEE检查、术中TEE监测,术后早期经胸超声心动图复查,并定期随访。结果:二尖瓣成形术成功实施92例(95.83%),失败4例(4.17%);轻微反流组、轻度反流组术后左房重构均显著改善;轻微反流组、轻度反流组术后即刻二尖瓣反流量与术后早期二尖瓣反流量相关性良好(r=0.467、0.688,均P<0.05);随访结果:81例(88.04%)患者术后二尖瓣反流量保持在0~1级,4例(4.35%)患者术后二尖瓣反流量2级及以上,1例(1.09%)患者死于严重的心力衰竭。结论:术中TEE可以清晰显示复跳后二尖瓣装置的运行情况,为二尖瓣直视成形术中监测与手术效果评估提供了安全、简单、可靠的方法。Objective:To investigate the application value of intraoperative transesophageal echocardiography(TEE)in mitral valvuloplasty.Methods:A total of 96 patients scheduled for mitral valvuloplasty were examined by preoperative TEE,intraoperative TEE monitoring,early postoperative echocardiographic re-examination,and regular follow-up.Results:92 cases of mitral valvuloplasty were performed successfully(95.83%)and 4 cases were failed(4.17%).Left atrial remodeling in slight regurgitation group and mild regurgitation group were significantly improved.There was a good correlation between immediate TEE mitral regurgitation and early postoperative TEE mitral regurgitation in slight regurgitation group and mild regurgitation group(r=0.467,0.688,all P<0.05).In the follow-up results showed that,81 patients(88.04%)maintained the mitral regurgitation at 0 to1 grade after operation,4 patients(4.35%)maintained grade 2 or above,and 1 patient(1.09%)died of severe heart failure.Conclusion:Intraoperative TEE can clearly display the operation of mitral valve device after rebeating,which provides a safe,simple,and reliable method for intraoperative monitoring and surgical efficacy evaluation during mitral valvuloplasty.

关 键 词：经食管超声心动图 二尖瓣成形 二尖瓣关闭不全 

分 类 号：R445.1[医药卫生—影像医学与核医学]