摘要
目的：探讨经食管超声心动图（TEE）对外科微创室间隔缺损封堵术的应用价值。方法：回顾性分析2013年8月至2015年5月广州医科大学附属第一医院收治的224例TEE初筛可进行封堵的室间隔缺损（VSD）患者的临床资料,术中全部行TEE全程监测封堵过程,引导封堵器放置,术后即刻评价疗效。结果：224例VSD患者中成功实行封堵术206例,成功率为92%。手术时间30～255 min,平均时间（70.2±35.3）min。术后1年内定期随访,无封堵器脱落、移位、溶血和房室传导阻滞等并发症发生,仅2例出现中量以上残余分流和瓣膜反流。术后第一次复查时,左室舒张末内径为（29.3±5.9）mm,左室射血分数为（63.5±6.7）%,均较术前的（33.8±6.7）mm和（71.6±5.6）%明显降低（P〈0.05）。结论：经食管超声心动图对室间隔缺损微创封堵术病例术前评估、术中监测引导及术后即刻评价疗效均有重要而可靠的应用价值。
Objective： To investigate the clinical value of transesophageal echocardiography in monitoring the minimally invasive transthoracic closure of ventricular septal defect（ VSD）. Methods： The clinical data of224 VSD patients,who were hospitalized in the First Affiliated Hospital of Guangzhou Medical University between August 2013 and May 2015,and underwent transthoracic echocardiography（ TEE） in preliminary screening for closure,were analyzed retrospectively. All patients underwent transesophageal echocardiography in monitoring the whole process of closure during the operation to guide the placement of occludes. The effects were evaluated immediately after the operation. Results： In 224 patients with VSD,206 patients underwent successful closure,with a success rate of 92%. The operation time was 30-255 min,and the mean time was（ 70. 2 ± 35. 3） min. All patients were followed up regularly for 1 year after the operation. No shedding and shift of occluder, or complications of hemolysis and atrioventricular block occurred. More than median amount of residual shunt and valvular regurgitation occurred in 2 cases. At the first reexamination after the operation,the left ventricular end diastolic diameter was（ 29.3±5.9） mm and the left ventricular ejection fraction was（ 63.5±6.7） %,which were significantly decreased compared with preoperative（ 33.8±6.7） mm and（ 71.6±5.6） %,respectively（ P〈0.05）.Conclusion： Transesophageal echocardiography shows significant and reliable value in the preoperative evaluation,intraoperative monitoring and guidance,and postoperative immediate evaluation of minimally invasive transthoracic closure of VSD.
出处
《广州医科大学学报》
2016年第5期25-29,共5页
Academic Journal of Guangzhou Medical University
关键词
经食管超声心动图
室间隔缺损
微创封堵
transesophageal echocardiography
ventricular septal defect
minimally invasive closure
