摘要
目的探讨经食管超声心动图用于体外循环下心脏瓣膜置换术的临床价值。方法选取甘肃省人民医院心外科2012年1月至2014年12月收治的89例体外循环下心脏瓣膜置换术患者,于术前、术中及术后行经食管超声心动图检查,同时术前行经胸超声心动图检查。比较术前经胸及经食管超声心动图检查测量获得的主动脉瓣环内径和钙化检出率,并比较患者术前、术后瓣膜及心功能指标变化。统计分析体外循环前应用经食管超声心动图补充诊断并更改手术方式的病例数、术中出现的特殊情况及处理结果、手术结果,同时随访6~40个月,统计分析随访结果。结果体外循环下心脏瓣膜置换术前,行经胸超声心动图测量主动脉瓣环内径及钙化检查率均低于手术病理结果,差异有统计学意义（P〈0.05）,经食管超声心动图二维多平面及三维检查结果与手术病理结果比较,差异均无统计学意义（均P〉0.05）;经食管超声心动图二维多平面及三维检查结果与经胸超声心动图结果比较,差异均有统计学意义（均P〈0.05）。结论对于体外循环下心脏瓣膜置换术患者,经食管超声心动图检查有助于指导瓣膜置换及手术方式选择,降低并发症发生率,提高手术成功率,值得临床上推广应用。
Objective To discuss the clinical value of transesophageal echocardiography used in extracorporeal circulationcardiac valve replacement. Methods 89 patients received extracorporeal circulation cardiac valve replacement in our hospital from January 2012 to December 2014 were included in the study. Transesophageal echocardiography were performed preoperatively, intraoperation and postoperatively and the findings were compared to the result of preoperation transthoracic echocardiography exam. The measurement of aortic annulus diameter and detection rates of calcification obtained by transthoracic and transesophaged echocardiography were compared. Changes in heart function parameters before and after operation were compared. The alternations in surgery plan made after pre-operative transesophageal echocardiography exam and any relevant treatment or procedure performed according to intra- operation transesophageal echo findings were recorded. All the patients were followed up for 6 months -40 months. Results Before extracorporeal circulation cardiac valve replacement, the aortic annulus diameter measured and detection rates of calcification by transthoracic echocardiography were smaller and lower than actual surgical pathology results （P 〈 0. 05 ） . No differences in the results from transesophageal echocardiography of two-dimensional and three-dimensional examination when compared to pathological findings （P 〉 0. 05 ） . Conclusions For patients receiving extracorporeal circulation cardiac valve replacement, transesophagus echocardiography examination is helpful to guide the selection of valve stent and operation methods.
出处
《中国介入心脏病学杂志》
2016年第2期100-103,共4页
Chinese Journal of Interventional Cardiology
关键词
心脏瓣膜置换术
体外循环
经食管超声心动图
Cardiac valve replacement
Extracorporeal circulation
Transesophageal echocardiography
