CAJ | 학술논문

目的评价经食管超声心动图对风湿性二尖瓣狭窄患者左心房血栓诊断价值.方法 82例风湿性二尖瓣狭窄患者进行经胸和经食管超声心动图.结果 82例患者中,29例(35%)有左心房血栓,11例位于左心房体部,14例位于左心耳,4例二部位均有;16例患者有左心房自发性超声显影征(SEC),10例患者有单纯自发性超声造影征,6例同时有左心房血栓和自发性超声造影征.4例仅有左心房体部血栓,8例仅有左心耳部血栓,2例两个部位均有血栓,8例有SEC.在3例二尖瓣狭窄合并关闭不全患者,只有1例有SEC.左心房体部和心耳血栓及自发性超声显影征均在经胸超声心动图为阴性.结论左心房血栓和SEC是风湿性心脏病二尖瓣狭窄常见并发症,经食管超声心动图是敏感和特异的检测左心房血栓和SEC方法,因此,在二尖瓣狭窄患者进行介入治疗和电除颤治疗患者选择尤其重要.
목적 평개경식관초성심동도대풍습성이첨판협착환자좌심방혈전진단개치.방법 82례풍습성이첨판협착환자진행경흉화경식관초성심동도.결과 82례환자중,29례(35%)유좌심방혈전,11례위우좌심방체부,14례위우좌심이,4례이부위균유;16례환자유좌심방자발성초성현영정(SEC),10례환자유단순자발성초성조영정,6례동시유좌심방혈전화자발성초성조영정.4례부유좌심방체부혈전,8례부유좌심이부혈전,2례량개부위균유혈전,8례유SEC.재3례이첨판협착합병관폐불전환자,지유1례유SEC.좌심방체부화심이혈전급자발성초성현영정균재경흉초성심동도위음성.결론 좌심방혈전화SEC시풍습성심장병이첨판협착상견병발증,경식관초성심동도시민감화특이적검측좌심방혈전화SEC방법,인차,재이첨판협착환자진행개입치료화전제전치료환자선택우기중요.
Objective To observe the diagnostic value of transesophogeous echocardiography(TEE)for detection of left atrial thrombus in patients with rheumatic mitral valve disease.nethods Eighty-two patients with rheumatic mitral valve disease were enrolled.No anticoagulation treatment were administrated before TEE.Results Of 82 patients,29 patients(35%)had left atrial thrombus:11 in left atrial chamber,14 in left atrial appendege,and 4 in both left atrial body and left atrial appendege.16 patients had left atrial spontaneous echo contrast(SEC).10 of them had only SEC.6 had both SEC and left atrial thrombus.In 22 subgroup patients with lone mitral stenosis and atrial fibrilation,10 patients had left atrial tllrombus,8 patients had SEC.However,in 3 subgroup patients with mitral valve stenosis and regurgitation,only 1 patient had SEC.No left atrial thrombus was detected by transthoracic echocardiography.Conclusion Left atrial thrombus and SEC are common complications in patients with rheumatic mitral valve stenosis.especially with atrial fibrilation.TEE is a sensitive and specific method for the detection of left atrial thmmbus,especially in left atrial appendage.Accordingly,TEE should be routinely performed in patients with rheumatic mitral valve stenosis and atrial fibrilation,especially for the candidates of interventional or electral defibrilation therapies.