中国医药
中國醫藥
중국의약
CHINA MEDICINE
2014年
7期
960-962
,共3页
经食管超声心动图%继发性房间隔缺损%微创外科
經食管超聲心動圖%繼髮性房間隔缺損%微創外科
경식관초성심동도%계발성방간격결손%미창외과
Transesophageal echocardiography%Secondary atrial septal defect%Minimally invasive surgery
目的 采用经食管超声心动图(TEE)引导中央型房间隔缺损微创外科封堵术,评价TEE在该手术中的临床应用价值.方法 经胸超声心动图筛查选取中央型房间隔缺损(ASD)患者37例在河南省商丘市第一人民医院心外科行微创外科封堵术.全身麻醉状态下术前TEE再次筛查手术适应证患者,观察ASD的位置、大小、形态、各切面残余径线,准确定位,术中检测封堵全过程,术后即刻评价封堵效果.术后3个月、6个月、1年随访复查,观察有无封堵器移位脱落,有无残余分流及其他并发症.结果 术前经TEE再次筛查发现1例下腔型ASD,随改为体外循环下修补;36例患者行微创外科封堵术,其中术中封堵失败1例,后改为体外循环下修补,封堵成功率为97.2％ (35/36);余35例患者应用TEE与TTE所测ASD大小各参数无明显差异,在TEE引导下封堵成功,术后即刻评价发现有2例出现少量残余分流,术后3个月复查1例仍存在微量残余分流,余34例封堵器位置固定、完全闭合,闭合率为97.1％(34/35),有心大小及功能明显改善,各瓣膜功能及心功能正常,无严重传导阻滞发生.结论 TEE应用于继发孔中央型ASD微创外科封堵术,术前准确筛查定位,与术中所置封堵器大小及位置相吻合,术中全程监测,不影响手术视野,引导封堵器的放置,术后即刻评价疗效,为心外科医生提供可靠信息.
目的 採用經食管超聲心動圖(TEE)引導中央型房間隔缺損微創外科封堵術,評價TEE在該手術中的臨床應用價值.方法 經胸超聲心動圖篩查選取中央型房間隔缺損(ASD)患者37例在河南省商丘市第一人民醫院心外科行微創外科封堵術.全身痳醉狀態下術前TEE再次篩查手術適應證患者,觀察ASD的位置、大小、形態、各切麵殘餘徑線,準確定位,術中檢測封堵全過程,術後即刻評價封堵效果.術後3箇月、6箇月、1年隨訪複查,觀察有無封堵器移位脫落,有無殘餘分流及其他併髮癥.結果 術前經TEE再次篩查髮現1例下腔型ASD,隨改為體外循環下脩補;36例患者行微創外科封堵術,其中術中封堵失敗1例,後改為體外循環下脩補,封堵成功率為97.2％ (35/36);餘35例患者應用TEE與TTE所測ASD大小各參數無明顯差異,在TEE引導下封堵成功,術後即刻評價髮現有2例齣現少量殘餘分流,術後3箇月複查1例仍存在微量殘餘分流,餘34例封堵器位置固定、完全閉閤,閉閤率為97.1％(34/35),有心大小及功能明顯改善,各瓣膜功能及心功能正常,無嚴重傳導阻滯髮生.結論 TEE應用于繼髮孔中央型ASD微創外科封堵術,術前準確篩查定位,與術中所置封堵器大小及位置相吻閤,術中全程鑑測,不影響手術視野,引導封堵器的放置,術後即刻評價療效,為心外科醫生提供可靠信息.
목적 채용경식관초성심동도(TEE)인도중앙형방간격결손미창외과봉도술,평개TEE재해수술중적림상응용개치.방법 경흉초성심동도사사선취중앙형방간격결손(ASD)환자37례재하남성상구시제일인민의원심외과행미창외과봉도술.전신마취상태하술전TEE재차사사수술괄응증환자,관찰ASD적위치、대소、형태、각절면잔여경선,준학정위,술중검측봉도전과정,술후즉각평개봉도효과.술후3개월、6개월、1년수방복사,관찰유무봉도기이위탈락,유무잔여분류급기타병발증.결과 술전경TEE재차사사발현1례하강형ASD,수개위체외순배하수보;36례환자행미창외과봉도술,기중술중봉도실패1례,후개위체외순배하수보,봉도성공솔위97.2％ (35/36);여35례환자응용TEE여TTE소측ASD대소각삼수무명현차이,재TEE인도하봉도성공,술후즉각평개발현유2례출현소량잔여분류,술후3개월복사1례잉존재미량잔여분류,여34례봉도기위치고정、완전폐합,폐합솔위97.1％(34/35),유심대소급공능명현개선,각판막공능급심공능정상,무엄중전도조체발생.결론 TEE응용우계발공중앙형ASD미창외과봉도술,술전준학사사정위,여술중소치봉도기대소급위치상문합,술중전정감측,불영향수술시야,인도봉도기적방치,술후즉각평개료효,위심외과의생제공가고신식.
Objective To observe the application of transesophageal echocardiography (TEE) guide the central type atrial septal defect occlusion during the minimally invasive surgery,and to evaluate the clinical value of TEE in the operation.Methods Totally 37 patients were studied in the first people's hospital of Shangqiu city cardiac surgery.We reassessed the sizes of the atrial septal defects and the margins,the suitable occluders by TEE,the atrial septal defect location,size,shape,each section of residual diameter,etc.After 3 months,6 months,1 year,patients were followed up to observe whether the occluder shift or off,with or without residual shunt and other complications.Results After preoperative TEE screening found inferior vena type atrial septal defect 1 case again.The occluder was successfully implanted in 35 patients.2 patients were found with trace residual shunt and only 1 patient was found residual shunt after 3 months.Follow-up at intervals showed that the occluders stayed firmly.There was no residual shunt or valve regurgitation.Conclusion Transesophageal echocardiography can guide minimally invasive closure.
