心血管手术麻醉管理中食管超声监测的应用及意义

发布时间：2018-05-30 23:03

本文选题：经食管超声心动图 + 心脏外科手术　；参考：《广东医学》2015年07期

【摘要】：目的评价经食管超声心动图在心脏外科手术中的临床应用价值。方法接受心脏外科手术的心脏病患者168例,在麻醉后,对所有患者进行经食管超声心动图连续检查,监测手术过程并评价手术效果。结果 77例先天性心脏病矫治患者中,16例室间隔缺损在术中食管超声引导下行小切口经右心室穿刺封堵术,1例患儿在麻醉后手术前纠正误诊;45例瓣膜置换患者中,13例联合瓣膜病变患者参照食管超声结果最终确定手术方案,1例二尖瓣置换术后三维食管超声及时发现卡瓣;1例拟行带瓣升主动脉人造血管置换术患者结合手术前食管超声结果改变术式;1例肝癌合并上腔静脉取癌栓患者在食管超声指引下非体外循环完成手术。结论经食管超声心动图用于心脏外科围术期监测,可及时发现围术期手术相关问题、指引手术操作、提高手术成功率。
[Abstract]:Objective to evaluate the clinical value of transesophageal echocardiography in cardiac surgery. Methods 168 patients with heart disease underwent cardiac surgery. After anesthesia, transesophageal echocardiography was performed on all patients to monitor the operation process and evaluate the effect of the operation. Results among 77 patients with congenital heart disease, 16 patients with ventricular septal defect underwent transventricular puncture and closure via right ventricular puncture under the guidance of esophageal ultrasound during operation. One child corrected misdiagnosis before operation after anesthesia in 45 patients with valve replacement. 13 patients with combined valvular disease confirmed the operative plan according to the results of esophageal ultrasound. One patient with valve replacement was diagnosed by three-dimensional esophageal ultrasound in time after mitral valve replacement and 1 patient with aortic prosthesis with valve replacement was performed combined with operation. The results of anterior esophageal ultrasound were changed in one patient with liver cancer complicated with superior vena cava embolus. The operation was performed without cardiopulmonary bypass under the guidance of esophageal ultrasound. Conclusion Transesophageal echocardiography can be used to detect perioperative problems in cardiac surgery, to guide the operation and to improve the success rate.
【作者单位】：广州中医药大学第二临床医学院麻醉科;
【分类号】：R614

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