CAJ | 학술논문

目的探讨经食管超声心动图(TEE)在儿童先天性心脏病围术期的应用价值.方法 2011年7月至2012年12月393例先天性心脏病患儿,男246例,女147例;年龄1天～14岁,中位月龄12个月;其中最低体质量1.8 kg.NYHAⅡ～Ⅳ级.回顾性总结患儿围术期应用经TEE检查的情况.结果经TEE检查对手术及治疗产生影响者60例(15.3％),其中术前对经胸超声心动图(TTE)诊断做出修正者4例(1.0％),需补充者4例(1.0％),需辅助诊断者4例(1.0％),11例(2.8％)对选择或更改手术方案产生了影响.术中发现残余问题者29例(7.4％),需辅助诊断者11例(2.8％).术后发现残余问题者7例(1.8％),需辅助诊断者1例(0.3％).操作过程中9例(2.3％)发生相关并发症,其中口、咽黏膜出血7例(1.8％),气管导管脱出2例(0.5％).结论先天性心脏病患儿围术期行TEE检查,对明确术前诊断、制定手术方案、即刻评估手术效果、发现残余问题和指导治疗策略具有重要意义.
목적 탐토경식관초성심동도(TEE)재인동선천성심장병위술기적응용개치.방법 2011년7월지2012년12월393례선천성심장병환인,남246례,녀147례;년령1천～14세,중위월령12개월;기중최저체질량1.8 kg.NYHAⅡ～Ⅳ급.회고성총결환인위술기응용경TEE검사적정황.결과 경TEE검사대수술급치료산생영향자60례(15.3％),기중술전대경흉초성심동도(TTE)진단주출수정자4례(1.0％),수보충자4례(1.0％),수보조진단자4례(1.0％),11례(2.8％)대선택혹경개수술방안산생료영향.술중발현잔여문제자29례(7.4％),수보조진단자11례(2.8％).술후발현잔여문제자7례(1.8％),수보조진단자1례(0.3％).조작과정중9례(2.3％)발생상관병발증,기중구、인점막출혈7례(1.8％),기관도관탈출2례(0.5％).결론 선천성심장병환인위술기행TEE검사,대명학술전진단、제정수술방안、즉각평고수술효과、발현잔여문제화지도치료책략구유중요의의.
Objective To evaluate the role of transesophageal echocardiography (TEE) in perioperative period of pediatric patients with congenital heart disease (CHD).Methods From July 2011 to December 2012,TEE was used in 393 pediatric patients(≤ 14 years) with congenital heart disease in perioperative period.We make a retrospective review with the clinical data of these cases.Results Operative schemes or therapeutic schedules of 60 patients(15.3％) were altered according to TEE.By preoperative TEE,the diagnosis of transthoracic echocardiography (TTE) of 4 cases(1.0％) were amended,4 cases (1.0％) were complemented,and 4 cases (1.0％) got the auxiliary diagnosis,among which operative schemes of 11 cases (2.8％)were altered.During the operate,29 cases(7.4％) found residual problems,11 cases(2.8％) got the auxiliary diagnosis.By postoperative TEE,7 cases(1.8％) found residual problems,1 case(0.3％) got the auxiliary diagnosis.Complications occurred in 9 cases(2.3％) of the 393 patients.Oral and pharyngeal mucous membrane bleeding occurred in 7 cases (1.8％),inadvertent tracheal extubation in 2 cases(0.5％).Conclusion TEE plays an important role in confirming preoperative diagnoses,formulating surgical plans,evaluating immediate operative results,identifying patients with residual defects and guiding the therapeutic schedule in perioperative period of pediatric patients with congenital heart disease.