经皮房间隔缺损封堵术中实时三维经食管超声心动图的效果分析  

作　　者：胡国梁[1] 蔡洁[1] 倪成香 范霜月 范庆浩[1] 

机构地区：[1]浙江省金华市人民医院,321099

出　　处：《浙江临床医学》2023年第10期1527-1529,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省金华市科技计划项目(2018-4-053)。

摘　　要：目的分析实时三维经食管超声心动图(RT-3D-TEE)用于房间隔缺损(ASD)患者中的价值。方法选取30例ASD患者为观察对象,全部接受经皮房间隔缺损封堵术,分别在手术过程中切换二维和三维经食管超声心动图,分析相关的检测参数。结果两种检测方法比较,下腔静脉侧残缘、主动脉侧残缘参数差异无统计学意义(P>0.05),RT-3D-TEE检测的上腔静脉残缘长度大于2D-TEE(P<0.05),RT-3D-TEE的ASD直径大于2D-TEE(P<0.05)。与术前1 d相比,术后3 d、1周、1个月、3个月左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、左室每搏输出量(LVSV)水平上升,右室舒张末期容积(RVEDV)、右室收缩末期容积(RVESV)、右室每搏输出量(RVSV)水平下降(P<0.05)。左室射血分数(LVEF)、右室射血分数(RVEF)水平术前、术后无明显变化(P>0.05)。结论RT-3D-TEE能更准确测量房间隔缺损的大小和残缘的长短,有利于临床严格把控房间隔缺损封堵适应证;同时术中采用实时RT-3D-TEE引导,明显减少封堵器释放次数及缩短操作时间,封堵术后效果良好。Objective To analyze the value of real-time three-dimensional transesophageal echocardiography(RT-3D-TEE)in patients with atrial septal defect(ASD).Methods Thirty patients with ASD were selected as subjects,all of whom underwent percutaneous closure of atrial septal defect.During the operation,two-dimensional and three-dimensional transesophageal echocardiography were switched,and the relevant detection parameters were analyzed.Results Compared with the two methods,there was little difference in the parameters of inferior vena cava residual margin and aortic residual margin(P>0.05).The length of superior vena cava residual margin detected by RT-3D-TEE was greater than 2D-TEE(P<0.05),and the ASD diameter of RT-3D-TEE was greater than 2D-TEE(P<0.05).Compared with 1 day before surgery,the levels of left ventricular end diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV)and left ventricular-stroke volume(LVSV)increased and the levels of right ventricular end-diastolic volume(RVEDV),right ventricular end-systolic volume(RVESV)and right ventricular stroke volume(RVSV)decreased at 3 days,1 week,1 month and 3 months after surgery(P<0.05).left ventricular ejection fraction(LVEF)and right ventricular ejection fraction(RVEF)levels were not changed before and after surgery(P>0.05).Conclusion RT-3D-TEE can more accurately measure the size of atrial septal defect and the length of residual margin,which is beneficial to strictly control the indication of atrial septal defect plugging.At the same time,real-time RT-3D-TEE guidance is adopted during the operation,which significantly reduces the number of occluder release and shortens the operation time,and the postoperative effect is good,worthy of promotion.

关 键 词：RT-3D-TEE 经皮房间隔缺损封堵术 心功能 二维超声 

分 类 号：R540.45[医药卫生—心血管疾病]