机构地区:[1]河南省南阳市第二人民医院超声科,473000
出 处:《实用医技杂志》2023年第2期105-108,共4页Journal of Practical Medical Techniques
摘 要:目的探讨对心脏瓣膜置换术后即刻人工瓣膜功能异常展开术中经食管超声心动图诊断的临床价值。方法选取我院2020年7月至2022年8月的84例心脏瓣膜置换术患者作为研究对象。其中主动脉瓣狭窄32例,属于关闭不全20例,属于狭窄合并关闭不全10例,属于二尖瓣狭窄22例。病变程度均在中度以上;针对所有研究对象在实施手术过程中,展开经食管超声心电图检查,记录患者主动脉瓣环钙化斑块以及内径情况,对主动脉瓣内直径加以计算。记录心脏收缩功能,就血管内钙化、血栓以及钙化斑块情况。手术后,对人工瓣膜的正常情况加以观察,对心脏血容量、收缩以及瓣膜闭合等情况重点分析。对所有患者手术前后的心功能情况以及瓣膜情况加以比较,就心脏瓣膜置换术后采用术中经食管超声心动图完成即刻评估的价值加以分析。结果在主动脉瓣环内径方面,同手术病理结果比较,二维超声的差异有统计学意义(P<0.05);同手术前比较,手术后患者的左室射血分数(61.33±4.39)%、主动脉平均跨膜压差(45.32±3.49)mmHg以及有效瓣口面积指数(0.99±0.25)cm^(2)均差异有统计学意义(t=23.1253,14.3631,15.2031,P<0.05)。所有患者均顺利完成心脏瓣膜置换术,其中需要更换新的人工瓣膜患者2例。术后均获得顺利恢复,未表现出院内死亡的情况。结论心脏瓣膜置换术患者在手术过程中,选择经食管超声心动图方法对人工瓣膜功能异常进行及时确定,对于内源性因素协助判定,可提升心脏瓣膜置换术成功率。Objective To explore the clinical value of transesophageal echocardiography in the diagnosis of abnormal artificial valve function immediately after cardiac valve replacement.Methods 84 patients with heart valve replacement in our hospital from July 2020 to August 2022 were selected as research objects.There were 32 cases of aortic stenosis,20 cases of insufficiency,10 cases of stenosis combined with insufficiency,and 22 cases of mitral stenosis,all of which were of moderate degree or above.During the operation,transesophageal echocardiographic examination was carried out reasonably for all study subjects,the calcified plaques and inner diameter of the aortic valve ring were carefully recorded,and the inner diameter of the aortic valve was calculated.Carefully observe the systolic function of the heart and clarify the size of calcification,thrombus,and calcified plaques in the blood vessels.After the surgery,the normal condition of the artificial valve was observed,and the heart blood volume,contraction and valve closure were analyzed.The cardiac function and valve status of all patients were compared before and after surgery,and the value of intraoperative transesophageal echocardiography for immediate evaluation after heart valve replacement was analyzed.Results Clinical analysis of the surgical pathology and transesophageal echocardiographic findings revealed statistically significant differences(P<0.05)in 2D ultrasound compared to surgical pathology.The left ventricular ejection fraction(61.33±4.39)%,the mean aortic transmembrane pressure difference(45.32±3.49)mmHg and the effective valve area index(0.99±0.25)cm^(2) of the patients after surgery were significantly different from those before surgery(P<0.05,t=23.1253,14.3631,15.2031).All patients had successful heart valve replacements,including two patients who required new prosthetic valves.All of them had a successful postoperative recovery and did not exhibit in hospital mortality.Conclusion The reasonable choice of transesophageal echocardiography for
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