摘要
目的通过经食管超声心动图(TEE)对儿童法洛四联症(TOF)根治术手术前后进行监测,并与手术前后经胸超声心动图(TTE)进行对比,评价TEE在TOF根治术中的应用价值。资料与方法对行TOF根治术的32例患儿进行回顾性分析。所有患儿术前及术中均运用TEE测量和分析房室腔大小、右心室流出道内径、室间隔周围有无残余分流、肺动脉主干内径、肺动脉瓣口流速及压差、右心室流出道压差,并与手术前后TTE测量值进行比较。结果 32例TOF患儿中,术前TEE对TTE做出修正诊断1例(3%),补充诊断1例(3%)。32例患儿术前TEE与手术结果疾病诊断符合率为100%(32/32)。术中经TEE检查发现手术残余问题7例(21.9%)。术前及术中TEE测量右心室流出道压差与手术前后TTE测量值差异有统计学意义(P<0.05)。术中TEE测量右心室流出道的结果较术后TTE测量值降低约28%。术后TEE测量的房室腔大小、右心室流出道内径、肺动脉瓣口流速与术后TTE测量值相关性良好(r=0.75~0.87,P<0.05),术中TEE测得右心室流出道压差与术后TTE测量值呈正相关(r=0.518,P<0.05)。术中TEE测量的房室腔大小、右心室流出道内径、肺动脉瓣口流速和压差、右心室流出道压差和术后TTE测量值差异均无统计学意义(P>0.05)。结论应用TEE在TOF根治术中进行监测对于术前诊断的修正和补充以及术后即刻评估手术疗效具有重要应用价值。
Purpose To evaluate clinical value of transesophageal echocardiography（TEE） on total correction of tetralogy of Fallot（TOF） through preoperative and postoperative monitoring of TEE in paediatrics total correction of TOF and comparison with preoperative and postoperative transthoracic echocardiography（TTE）. Materials and Methods Thirty-two children patients receiving total correction of TOF were retrospectively analyzed. TEE was adopted to measure atrial and ventricular cavity size, diameter of right ventricular outflow tract, residual shunt surrounding ventricular septum, diameter of pulmonary artery trunk, orifices flow rate and differential pressure of pulmonary artery and differential pressure of right ventricular outflow tract for all patients preoperative and intraoperative. Meanwhile, all these were compared with value measured by TTE before and after the surgery. Results Among the 32 TOF patients, preoperative TEE figured out one revised diagnosis（3%） of TTE and one supplementary diagnosis（3%）. Coincidence rate of disease diagnosis of preoperative TEE and surgical outcome of the 32 patients was 100%（32/32）. Intraoperative TEE examination found out 7（21.9%） with residual surgical issues. Differential pressure of right ventricular outflow tract measured by preoperative and intraoperative TEE and value measured by preoperative and postoperative TTE was of statistical significance（P〈0.05）. Right ventricular outflow tract measured by intraoperative TEE was obviously reduced by approximately 28% compared with the value measured by postoperative TTE. Correlation of atrial and ventricular cavity size, diameter of right ventricular outflow tract and orifices flow rate of pulmonary artery measured by intraoperative TEE and value measured by postoperative TTE were well（r=0.75-0.87, P〈0.05）. Differential pressure of right ventricular outflow rate measured by intraoperative TEE was positively correlated with value measured by postoperative TTE（r=0.518, P〈0.05）. Difference o
作者
胡原
彭颖慧
黄鹏
陈文娟
HU Yuan;PENG Yinghui;HUANG Peng;CHEN Wenjuan(Department of Ultrasound,Hunan Children＇s Hospital,Changsha 410007,China)
出处
《中国医学影像学杂志》
CSCD
北大核心
2017年第11期841-844,共4页
Chinese Journal of Medical Imaging
关键词
法洛四联症
超声心动描记术
经食管
心脏外科手术
儿童
Tetralogy of Fallot
Echocm-diography
transesophageal
Cardiac surgical procedures
Child
