多平面经食管超声心动图在风心病手术方式选择中的价值  

Evaluation of Multiplane Transesophageal Echocardiography(MTEE)for the Selected Operation of Rheumatic Heart Disease(RHD)

作　　者：丁萍[1] 徐晓文[2] 章雪林[2] 林斌[3] 张运[4] 

机构地区：[1]台州市中心医院超声科,浙江省318000 [2]台州市中心医院心外科,浙江省318000 [3]台州市中心医院心内科,浙江省318000 [4]山东大学齐鲁医院心内

出　　处：《中国超声医学杂志》2003年第9期678-680,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 :研究应用多平面经食管超声心动图 (TEE)和彩色多普勒血流显像 (CDFI)相结合 ,评价该技术在风湿性心瓣膜病手术方式选择中的价值。方法 :57例风心病术前应用经胸超声 (TTE)和经食管超声两种方法进行检查 ,重点探查左房血栓、左房云雾影、瓣膜返流和瓣膜病变等方面并对两种方法进行比较。结果 :TEE检查 :拟行二尖瓣置换 30例 ;球囊扩张 1 5例 ;主动脉瓣病变 5例 ,3例瓣膜置换、 2例未确定 ,拟 6例双瓣置换。TEE检查后 :原 30例拟行二尖瓣置换中改二尖瓣修复术 3例 ,改双瓣置换 3例 ;原 1 5例拟行球囊扩张者 ,新发现左心耳血栓 8例 ,改二尖瓣置换 5例 ;原 3例主动脉瓣置换及 2例主动脉瓣病变未确定者均行主动脉瓣置换 ;原6例双瓣置换 ,1例改主动脉瓣置换加二尖瓣修复术 ;均与手术相符。结论 :TEE在风湿性心瓣膜病手术方式选择中有决定性作用 ,在左房血栓、左房云雾影的检出及二尖瓣返流的定量和主动脉瓣病变的判断中 TEE较 TTE优越 。Objective:To study on the combination o f MTEE and Doppler color flow imaging(DCFI)for the selected operation on rheumat ic heart disease(RHD).Methods:Before operation,75 cases w ith RHD were examined with TTE and MTEE.Two methods were compared especially for left atrial thrombi,spontaneous echo contrast,valvular regurgitation and valvul ar lesion.Results:After TEE examination,3 of the 30 cases for mit ral valve replacement were changed to repair,and 3 for double valvular replacement. Eight of the 15 cases for balloon dilation were found thrombi on left atrial app endage,and 5 of them were changed for mitral replacement.Five cases of aortic va lvular diseases who originally needed replacment were changed to aortic relaceme nt and mitral repair.All of these were coincident with operation.Conclusions:TEE plays an crucial role for the election of operation on rheumatic valvualr diseases and is superior to TTE especially for t hrombus and spontaneous echo contrast detection of left atrium,mitral regurgitat ion and aortic valvular diseases.The results are accurate and reliable.

关 键 词：多平面经食管超声心动图 手术方式 选择 风湿性心瓣膜病 瓣膜置换术 

分 类 号：R445.1[医药卫生—影像医学与核医学]