心腔内声学造影技术在单纯经胸超声心动图引导下经皮行心房水平缺损封堵术中应用的安全性及临床价值  

Safety and Application Value of Intracardiac Contrast Echocardiography in Percutaneous Closure of the Defect Between the Atria Guided by Transthoracic Echocardiography

作　　者：唐仕海 刘浪 赵飞[1] 郑波 何佳林 邵剑鹏 Tang Shihai;Liu Lang;Zhao Fei(CardiovasculaRDepartment of the People′s Hospital of Leshan,Leshan,Sichuan 614000,China.)

机构地区：[1]乐山市人民医院心脏大血管外科,四川乐山614000

出　　处：《四川医学》2024年第5期517-522,共6页Sichuan Medical Journal

基　　金：四川省医学青年创新科研课题(编号:Q20065);乐山市重点研究课题(编号:20SZD036)。

摘　　要：目的探讨心腔内声学造影(ICCE)在单纯经胸超声心动图(TTE)引导下行心房水平缺损介入封堵术中应用的安全性及临床价值。方法回顾性分析我院2021年4月至2022年7月单纯TTE引导下经皮行心房水平缺损介入封堵术且术中予以含血激活生理盐水行ICCE的病例资料,共148例,诊断房间隔缺损9例,诊断卵圆孔未闭139例,平均年龄(47.53±14.52)岁。统计患者术前基线资料,比较ICCE前后基础生命体征变化等。统计经ICCE校正后单纯TTE判断端孔导管通过卵圆孔进入左心系统正确率。结果直接予以含血激活生理盐水行ICCE前后基础生命体征结果比较,差异无统计学意义(P>0.05);单纯TTE判断端孔导管通过卵圆孔未闭的正确率,经ICCE校正为73.77%,单纯TTE判断与ICCE辅助下判断结果比较,差异有统计学意义(P<0.05)。结论ICCE以含血激活生理盐水作为造影剂是安全、可行的,辅助判断端孔导管的位置,可以极大降低单纯TTE引导下心脏介入封堵手术的难度,尤其是卵圆孔未闭封堵,并促进此术式的推广。Objective The purpose of this study was to evaluate the safety and application value of intracardiac contrast echocardiography(ICCE),which was being used inpercutaneous closure of the defect between the atria guided by transthoracic echocardiography(TTE)alone.Methods A retrospective analysis was performed on patients who underwent percutaneous closure of the defect between the atria undeRthe guidance of TTE,in which agitate air-blood-saline mixture was used to perform ICCE during the procedure from April 2021 to July 2022 in ouRhospital,including 9 cases of atrial septal defect and 139 cases of patent foramen ovale with an average age of(47.53±14.52)years.Preoperative baseline data of patients was collected.The changes of vital signs of pre-ICCE and post-ICCE were compared.The accuracy judged by TTE alone,whetheRthe terminal of catheteRpassed the PFO oRnot,was estimated by ICCE.Results The differences of vital signs the pre and post-ICCE with agitate air-blood-saline directly injected in intracardiac were not statistically significant(P>0.05).The accuracy judged by TTE alone,whetheRthe terminal of catheteRpassed the PFO oRnot,was 73.77%,which was statistically significant compared with the result judged by ICCE(P<0.05).Conclusion The procedure of intracardiac contrast echocardiography using the agitated air-blood-saline as contrast agent is safe and feasible.It can be used to judge where the terminal of the catheteRis.It can reduce the difficulty of cardiac interventional occlusion guided by TTE alone,especially foRPFO-occlusion,and also promote the implementation of this surgery.

关 键 词：含血激活生理盐水 心腔内声学造影 经胸超声心动图 卵圆孔未闭 房间隔缺损 

分 类 号：R540.45[医药卫生—心血管疾病] R654.2[医药卫生—内科学]