中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2013年
9期
47-50
,共4页
经食管超声心动图描记术%左心房%血栓%二尖瓣球囊瓣膜成形术
經食管超聲心動圖描記術%左心房%血栓%二尖瓣毬囊瓣膜成形術
경식관초성심동도묘기술%좌심방%혈전%이첨판구낭판막성형술
Echocardiography transesophageal%Left atrium%Thrombus%Percutaneous balloon mitral vavuloplasty
目的 探讨食管超声心动图(TEE)在风湿性二尖瓣及其他瓣膜病变损害介入治疗中的应用价值.方法 术中在TEE监视引导下,引导导丝和导管避开左心耳及附近左房壁的血栓,即刻评定球囊扩张的效果,预防并发症的发生.结果 在左房及耳部存在机化性血栓、直径(ψ)≤1.0 cm的左心耳孤立性低回声宽基底的附壁血栓,行二尖辩球囊瓣膜成形术(PBMV)未出现栓塞并发症；房间隔缺损伴风湿性心脏病二尖瓣狭窄(Lutembacher综合征)先行PBMV术,后用Amplatzer伞对房间隔缺损进行封堵获得成功.对妊娠合并风湿性二尖瓣狭窄、老年性风湿性二尖辩狭窄行PBMV术,疗效满意.结论 TEE为PBMV在术前适应证的判定及术中提供了新的监测手段,在左房存在血栓条件下,使PBMV术由禁忌证变成相对适应证,缩短了病程,提高了介入性手术治疗的安全性、精确性和成功率.
目的 探討食管超聲心動圖(TEE)在風濕性二尖瓣及其他瓣膜病變損害介入治療中的應用價值.方法 術中在TEE鑑視引導下,引導導絲和導管避開左心耳及附近左房壁的血栓,即刻評定毬囊擴張的效果,預防併髮癥的髮生.結果 在左房及耳部存在機化性血栓、直徑(ψ)≤1.0 cm的左心耳孤立性低迴聲寬基底的附壁血栓,行二尖辯毬囊瓣膜成形術(PBMV)未齣現栓塞併髮癥；房間隔缺損伴風濕性心髒病二尖瓣狹窄(Lutembacher綜閤徵)先行PBMV術,後用Amplatzer傘對房間隔缺損進行封堵穫得成功.對妊娠閤併風濕性二尖瓣狹窄、老年性風濕性二尖辯狹窄行PBMV術,療效滿意.結論 TEE為PBMV在術前適應證的判定及術中提供瞭新的鑑測手段,在左房存在血栓條件下,使PBMV術由禁忌證變成相對適應證,縮短瞭病程,提高瞭介入性手術治療的安全性、精確性和成功率.
목적 탐토식관초성심동도(TEE)재풍습성이첨판급기타판막병변손해개입치료중적응용개치.방법 술중재TEE감시인도하,인도도사화도관피개좌심이급부근좌방벽적혈전,즉각평정구낭확장적효과,예방병발증적발생.결과 재좌방급이부존재궤화성혈전、직경(ψ)≤1.0 cm적좌심이고립성저회성관기저적부벽혈전,행이첨변구낭판막성형술(PBMV)미출현전새병발증；방간격결손반풍습성심장병이첨판협착(Lutembacher종합정)선행PBMV술,후용Amplatzer산대방간격결손진행봉도획득성공.대임신합병풍습성이첨판협착、노년성풍습성이첨변협착행PBMV술,료효만의.결론 TEE위PBMV재술전괄응증적판정급술중제공료신적감측수단,재좌방존재혈전조건하,사PBMV술유금기증변성상대괄응증,축단료병정,제고료개입성수술치료적안전성、정학성화성공솔.
Objective To investigate the application value of transesophageal echocardiography (TEE) on patients with rheumatic mitral valve disease and other valve diseases.Methods TEE provides a live and clear planar picture showing the atrial septum,puncture needle and the dilatation of the balloon catheter.The guide wire and catheter were kept away from atrial thrombi in the intervenient procedure avoiding of thrombus.Results No thrombosis was found in patients with organization thrombus in the left atrium or left atrial appendage in PBMV,none was found in those with isolated low-echoed thrombi (ψ≤ 1.0 cm) in the left atrial appendage.Atral septal defect was closed successfully with amplatzer septal occluder after PBMV in one case of Lutembacher' s syndrome.To pregnancy with rheumatoid mitral stenosis and senile rheumatoid mitral stenosis,PBMV had good curative effect.Conclusions Application of TEE can improve the safety,accuracy and successful rate in PBMV and convert the forbiddance into relative application in patients with left atrial thrombi.
