术中经食管超声心动图在心脏外科手术中的应用价值  

Application value of intraoperative transesophageal echocardiography in cardiac surgery

作　　者：许洋洋 XU Yangyang(Echocardiography Room,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou362000,China)

机构地区：[1]福建医科大学附属泉州第一医院心脏彩超室,福建泉州362000

出　　处：《中国现代医生》2021年第7期119-122,F0003,共5页China Modern Doctor

摘　　要：目的探讨术中经食管超声心动图(TEE)在心脏外科手术中的应用价值。方法回顾性分析2017年1月至2020年6月在我院心外科手术并行术中TEE监测的143例患者,比较术前经胸超声心动图(TTE)检查与TTE联合TEE的诊断符合率,总结术前TEE的补充诊断及对术式的影响,总结术后即刻TEE检查的异常结果及外科处理。结果与手术结果对比,术前TTE检查,完全符合率为86.71%,TTE联合TEE诊断后,完全符合率提高到99.12%,差异有统计学意义(P<0.05);术前TEE检查补充诊断16例,包括瓣膜赘生物4例,卵圆孔未闭4例,房间隔缺损2例,房间隔膨胀瘤+卵圆孔未闭1例,右冠窦瘤破入右室1例,左心耳血栓+二尖瓣机械瓣瓣架血栓1例,二尖瓣生物瓣瓣周漏1例,左心耳血栓1例,左房多发肿瘤1例,其中8例改变手术方案;术后即刻TEE评估手术效果,11例再次进行外科干预处理。结论术中TEE既能在术前补充诊断,提高诊断符合率,影响手术方案的决策,又能在术后即刻评估手术效果,及时发现异常并指导外科补救,值得临床推广应用。Objective To explore the application value of intraoperative transesophageal echocardiography(TEE)in cardiac surgery.Methods A total of 143 patients who underwent TEE during cardiac surgery in our hospital from January 2017 to June 2020 were analyzed retrospectively.The diagnostic coincidence rate between preoperative transthoracic echocardiography(TTE)and TTE combined with TEE were compared.The supplementary diagnosis of TEE before operation and its influence on the operation method were summarized.The abnormal results and surgical treatment of TEE immediately after operation were recorded.Results Compared with the surgical results,the complete coincidence rate of TTE examination before operation was 86.71%,and after TTE combined with TEE diagnosis,the complete coincidence rate increased to 99.12%,with statistically significant difference(P<0.05).16 patients underwent preoperative TEE to supplement the diagnosis,including 4 cases of valvular neoplasm,4 cases of patent foramen ovale,2 cases of atrial septal defect,1 case of atrial septal aneurysm+patent foramen ovale,1 case of right coronary sinus tumor breaking into the right ventricle,1 case of left atrial appendage thrombus+mitral valve stent thrombus,1 case of mitral bioprosthetic valve leakage,1 case of left atrial appendage thrombus and 1 case of left atrial multiple tumors,among which 8 cases changed the operation plan.TEE was used to evaluate the effect immediately after operation,and 11 cases underwent surgical intervention again.Conclusion Intraoperative TEE can not only supplement the diagnosis before operation,improve the diagnostic coincidence rate and influence the decision-making of the surgical plan,but also evaluate the surgical effect immediately after operation,discover the abnormality in time and guide the surgical remedy,which is worthy of clinical application.

关 键 词：超声心动图 经食管 心脏手术 术中监测 

分 类 号：R445.1[医药卫生—影像医学与核医学]