北京生物醫(yī)學(xué)工程

經(jīng)食管超聲評(píng)價(jià)微創(chuàng)外科房間隔缺損封堵術(shù)中患者心功能及血流動(dòng)力學(xué)

Evaluation of cardiac function and hemodynamics in patients with intraoperative device closure of atrial septal defect by transesophageal echocardiography

作者：張麗華王巖劉愛(ài)琴封淑文黃建新杜巧

單位：武警北京市總隊(duì)第二醫(yī)院（北京100037）

關(guān)鍵詞：食管超聲；房間隔缺損；微創(chuàng)封堵術(shù)；心臟功能；血流動(dòng)力學(xué)

分類(lèi)號(hào)：

出版年·卷·期（頁(yè)碼）：2012·31·4（407-410）

摘要：

目的運(yùn)用經(jīng)食管超聲對(duì)微創(chuàng)外科房間隔缺損封堵術(shù)中患者心功能及血流動(dòng)力學(xué)的變化進(jìn)行評(píng)價(jià)，探討超聲在微創(chuàng)外科房間隔缺損封堵術(shù)中的應(yīng)用價(jià)值。方法門(mén)診篩查選擇適合經(jīng)微創(chuàng)外科封堵術(shù)治療的房間隔缺損患者50例，于術(shù)中及手術(shù)前后對(duì)患者進(jìn)行經(jīng)食管超聲和經(jīng)胸超聲心動(dòng)圖檢查，分別測(cè)量左、右室心功能及血流動(dòng)力學(xué)指標(biāo)，并對(duì)手術(shù)前后結(jié)果進(jìn)行對(duì)照比較。結(jié)果術(shù)后左、右房室腔的徑線與術(shù)前比較明顯減小（P<0.05），右心室舒張末期容積（RVEDV）、右心室每搏輸出量(RVSV)、右心排血量(CO)均較封堵前明顯減小，左心室舒張末期容積（LVEDV）、每搏輸出量(LVSV)及排血量(CO)均較封堵前增加，兩者具有顯著差異（P<0.05）。而左心室收縮末期容積（LVESV）和右心室收縮末期容積（RVESV）以及左室和右室射血分?jǐn)?shù)無(wú)顯著變化。術(shù)后肺動(dòng)脈瓣上最大血流速度、三尖瓣口E峰流速、三尖瓣反流最大流速及肺動(dòng)脈收縮壓與術(shù)前比較均顯著減小（P<0.05），二尖瓣口E峰流速顯著增大（P<0.05）。結(jié)論經(jīng)食管超聲可及時(shí)反映微創(chuàng)外科房間隔缺損封堵術(shù)前后患者心功能及血流動(dòng)力學(xué)變化，為臨床評(píng)價(jià)手術(shù)效果提供參考。

Objective To evaluate cardiac function and hemodynamics in patients with minimal-invasive surgical device closure of secundum atrial septal defects by transesophageal echocardiography, and to discuss the value of transesophageal echocardiography. Methods Echocardiography tests were performed in fifty patients with secundum atrial septal defects undergone minimal-invasive surgical device closure. The values of certain parameters for cardiac function and hemodynamics were measured and analyzed preoperatively and postoperatively. Results After operation, the size of both right and left ventricle and atrium decreased(P<0.05), the right ventricular end diastolic volume (RVEDV), right ventricular stroke volume (RVSV), right ventricular cardiac output(RVCO) decreased(P<0.05), the left ventricular end diastolic volume(LVEDV), left ventricular stroke volume (LVSV), left ventricular cardiac output(LVCO) increased(P<0.05), while the right ventricular end systolic volume(RVESV), left ventricular end systolic volume (LVESV), and the ejection fraction(EF) of both right and left ventricle changed not much. The peak velocity, mean velocity and velocity time integral of pulmonary valve, the peak velocity of E wave in tricuspid valve, the peak velocity of tricuspid regurgitation and the pulmonary artery systolic pressure decreased(P<0.05), while the peak velocity of E wave in mital valve increased(P<0.05). Conclusions Transesophageal echocardiography could be used as a tool in the evaluation of cardiac function and hemodynamics in patients with minimal-invasive surgical device closure of ecundum atrial septal defects.

參考文獻(xiàn)：

［1］Figueroa MI, Balaguru D,McClure C,et al.Experience with use of multiplance transesophageal echocardiography to guide closure of atrial septal defects using the amplatzer device［J］.Pediatr Cardiol,2002,23:430-436.
［2］陳國(guó)珍，黃國(guó)英.超聲心動(dòng)圖在先天性心臟病介入治療的應(yīng)用進(jìn)展［J］.國(guó)際兒科學(xué)雜志，2006,33（1）:3-6.
Chen Guozhen, Huang Guoying.Progress on application of echocardiography in interventional procedures of congenital heart disease［J］.Int J Pediatr，2006,33（1）:3-6
［3］唐虹，張爾永，謝俊敏，等.食管超聲心動(dòng)圖監(jiān)測(cè)下經(jīng)胸微創(chuàng)房間隔缺損封堵術(shù)［J］.中國(guó)胸心血管外科臨床雜志，2006,13（6）:349-351.
Tang Hong, Zhang Eryong, Xie Junmin,et al.Monitoring of transesophageal echocardiography in atrial septal defect occlusion during port-access minimally invasive cardiac surgery［J］.Chinese Journal of Clinical Thoracic and Cardiovascular Surgery,2006,13（6）:349-351.
［4］張麗華，李治安，張純.先天性心臟病鑲嵌治療及術(shù)中超聲的作用.中華醫(yī)學(xué)雜志，2007,87(40):2876-2878.
Zhang Lihua,Li Zhian,Zhang Chun.Hybrid therapy of congenital heart disease and the value of intraoperative ultrasonography.National Medical Journal of China,2007,87(40):2876-2878.

服務(wù)與反饋：

【文章下載】【加入收藏】

提示：您還未登錄，請(qǐng)登錄！點(diǎn)此登錄

51黑料吃瓜在线观看,51黑料官网|51黑料捷克街头搭讪_51黑料入口最新视频