卵圆孔未闭介入治疗中cTTE联合cTCD替代cTEE的可行性研究  

The feasibility study of cTTE combined cTCD instead of cTEE for patients with patent foramen ovale treated by interventional therapy

作　　者：马杰[1] 廖红娟[1] 张焱 张洁琼 李璐瑜 赵曙光[1] MA Jie;LIAO Hongjuan;ZHANG Yan(The Second Hospital of Hebei Medical University,Hebei,Shijiazhuang 050000,China;不详)

机构地区：[1]河北医科大学第二医院,石家庄市050000 [2]河北省优抚医院,石家庄市050000

出　　处：《河北医药》2022年第13期1996-1999,共4页Hebei Medical Journal

基　　金：河北省医学科学研究重点课题计划(编号:20221048)。

摘　　要：目的 探讨经胸超声心动图声学造影(cTTE)联合经颅多普勒超声学造影(cTCD)替代经食道超声心动图声学造影(cTEE)作为卵圆孔未闭(PFO)介入治疗前病例筛选检查的可行性及有效性;从而简化术前检查流程,降低术前检查风险、节省医疗成本。方法 选择2020年1月至2021年6月收治的800例高度疑似PFO患者,患者术前随机分成2组:cTTE组采用cTCD联合cTTE作为筛查PFO的方法,cTEE组采用cTCD联合cTEE作为筛查PFO的方法。患者行经导管PFO探查术以及经导管PFO封堵术。术后随访1年,检查患者封堵有效率、症状缓解率及术后并发症发生情况。结果 cTEE联合cTCD诊断敏感度(99.25%)及准确度(99.00%)略高于cTTE联合cTCD(97.98%、98.00%),但差异无统计学意义(P>0.05);术后随访1年,封堵术后1年封堵有效率为83.63%;术后3个月出现心悸46例,胸闷40例,胸痛36例,总发生率为15.25%;术后6个月内37例出现上述症状,发生率为4.63%;术后1年2例仍有上述症状,发生率为0.25%。结论 cTTE、cTEE分别联合cTCD均可诊断PFO,虽然cTEE联合cTCD的诊断效能更高,但cTEE、cTCD联合cTTE能高质量完成Valsalva动作,准确判断RLS来源及严重程度,且为无创检查,避免cTEE带来的潜在并发症,是筛查PFO安全有效的手段。Objective To investigate the feasibility and effectiveness of transthoracic echocardiographic contrast-enhanced(cTTE)instead of transesophageal echocardiographic contrast-enhanced(cTEE)as a case screening examination before interventional therapy for patents with patent foramen ovale(PFO),so as to simplify the preoperative examination process,reduce the risk of preoperative examination and save medical costs.Methods A total of 800 patients with highly suspected PFO who were treated in our hospital from January 2020 to June 2021 were enrolled in the study,were randomly divided into two groups.The patients in cTTE group were screened for PFO by using cTCD combined with cTTE,and the patients in cTEE group were screened for PFO by using cTCD combined with CTEE.Transcatheter PFO exploration and transcatheter PFO closure were performed for all the patients.After operation the patients in both groups were followed up for one year,and the effectiveness rate of closure,the symptom relief rate,and the incidence of postoperative complications were observed and compared between the two groups.Results The diagnostic sensitivity(99.25%)and accuracy(99.00%)by CTEE combined with cTCD were higher than those of ctte combined with cTCD(97.98%,98.00%,respectively).At 1-yaer follow up after operation,the effectiveness rate of closure was 83.63%;At 3 months after operation,46 patients had palpitation,40 cases had chest tightness,and 36 cases had chest pain,with total incidence rate being 15.25%.Within 6 months after operation,37 cases had above symptoms,with the incidence rate being 4.63%,moreover,2 cases had above symptoms at 1 year after surgery,with the incidence being 0.25%.Conclusion Both cTTE and cTTE alone and in combination with cTCD can diagnose PFO,although the diagnostic efficacy of cTEE combined with cTCD is higher,but,cTEE or TCD combined with cTTE can complete effectively the Valsalva maneuver,accurately judge the source and severity of RLS,which is an noninvasive examination way,and can avoid the occurrence of potential

关 键 词：卵圆孔未闭 经胸超声心动图声学造影 经食管右心声学造影 经颅多普勒超声学造影 介入封堵术 

分 类 号：R541[医药卫生—心血管疾病]