单纯超声心动图引导胸主动脉腔内隔绝术中的应用研究

发布时间：2018-05-07 20:41

本文选题：超声心动图 + 腔内隔绝术　；参考：《中国现代医学杂志》2015年18期

【摘要】：目的探讨应用单纯超声心动图在引导胸主动脉腔内隔绝术中的应用,包括超声心动图在术前检测、筛选病例,术中监测、引导置入覆膜支架和术后随访中的应用价值。方法 14例胸主动脉病变需行腔内隔绝术患者,术前通过经TTE结合CTA诊断、筛选病例,术中应用超声心动图再次评估病变,并全程单纯由超声心动图-经胸超声心动图(TTE)和经食道超声心动图(TEE)引导覆膜支架正确放置;术后经TTE对单纯超声引导腔内隔绝术成功患者进行定期随访,评估手术效果。结果 14例病例中,12例在单纯超声引导下成功置入覆膜支架,成功率85.7%,共计置入支架12个,所有病例术中超声心动图均能准确分辨真、假腔,对覆膜支架定位准确,近端破口或内膜溃疡被有效封闭。术后定期随访,覆膜支架位置固定好,无内漏、截瘫等严重并发症。结论单纯超声引导胸主动脉腔内隔绝术为胸主动脉病变的治疗提供了一种全新的思路和方法。超声心动图(含TTE、TEE)在单纯超声引导胸主动脉腔内隔绝术中对术前筛选病例、术中覆膜支架置入过程监测引导、术后评估疗效发挥重要作用。
[Abstract]:Objective to investigate the value of echocardiography in guiding thoracic aortic endovascular exclusion, including preoperative detection, selection of cases, intraoperative monitoring, guided stent placement and postoperative follow-up. Methods 14 patients with thoracic aortic disease needed endovascular exclusion. The patients were diagnosed by TTE and CTA before operation. Echocardiography was used to evaluate the disease again during operation. The stent was placed correctly by echocardiography-transthoracic echocardiography (TTE) and transesophageal echocardiography (TTE) during the whole course, and the successful patients were followed up regularly by TTE after operation to evaluate the effect of operation. Results among the 14 cases, 12 cases were successfully implanted with covered stent under the guidance of ultrasound alone, the success rate was 85.7%, and the total number of stents was 12. The echocardiography in all cases could accurately distinguish the true, false cavity, and locate the covered stent accurately. Proximal breaks or intimal ulcers are effectively closed. After regular follow-up, the stents were fixed well, without internal leakage, paraplegia and other serious complications. Conclusion Ultrasound-guided endovascular exclusion of thoracic aorta provides a new idea and method for the treatment of thoracic aortic disease. Echocardiography (including TTEOTEE) plays an important role in preoperative screening and monitoring of the procedure of stent implantation and evaluation of curative effect.
【作者单位】：中南大学湘雅二医院湖南省心血管病研究所心脏超声专科;中南大学湘雅二医院湖南省心血管病研究所心血管外科;
【基金】：湖南省科技厅(No:2012FJ6014)
【分类号】：R540.45;R543.1

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