心房颤动复律前经食管超声心动图检测左心房血栓的临床意义  

Transesophageal echocardiographic detection of left atrial thrombus and spontaneaus echo contrast before cardioversion of atrial fibrillation

作　　者：孙寅光[1] 施仲伟[1] 沈卫峰[1] 胡厚达[1] 潘秀芳[1] 

机构地区：[1]上海第二医科大学附属瑞金医院心脏科,200025

出　　处：《中华超声影像学杂志》2003年第8期468-469,共2页Chinese Journal of Ultrasonography

摘　　要：目的　评价经食管超声心动图 (TEE)在非瓣膜性心脏病心房颤动患者药物或电复律治疗中的作用。方法　 43例心电图证实的非瓣膜性心脏病心房颤动患者接受抗血小板或抗凝治疗并在复律治疗前 2 4～ 48h行经胸超声心动图和TEE检查。结果　TEE发现左心耳血栓 2例和左心房自发声影 3例 ,经抗凝或抗血小板治疗后 39例接受复律治疗 ,其中 31例药物复律 (成功 1 9例 ,失败 1 2例 ) ,8例接受电复律(成功 6例 ,失败 2例 )。所有患者在治疗期间均无血栓栓塞性并发症。结论　心房颤动患者早期接受复律治疗前 ,TEE探测心房血栓可作为指导抗凝治疗。Objective To evaluate the role of transeso phageal echocardiography(TEE) before chemical or electric cardioversion for non-vulvular atrial fibrillation. Methods Forty-three patients, confirmed non-vulvular atrial fibrillation, undertook anticoagulation or anti-platelet therapy and transthoracic echocardiography and TEE less than 24-48 hours prior to cardioversion. Results Two thrombi in the left atrial appendage and three spontaneous echo contrasts in the left atrium were evidenced. After anticoagulation or anti-platelet therapy, 39 patients undertook cardioversion therapy. Among them,31 patients received drug cardioversion,success in 19,and failure in 12;8 patients received electric cardioversion,success in 6,and failure in 2. There were no thromboembolic events during the hospitalization. Conclusions TEE performed before cardioversion for atrial fibrillation is necessary to reduce the risks of thromboembolic events and to guide for anticoagulation therapy.

关 键 词：心房颤动 经食管超声心动图 检测 左心房血栓 电复律 药物复律 

分 类 号：R445.1[医药卫生—影像医学与核医学] R543.2[医药卫生—诊断学]