经食管超声心动图与经胸超声心动图在儿童法洛四联症根治术前后诊断的比较

发布时间：2018-03-21 02:53

本文选题：法洛四联症　切入点：超声心动描记术　出处：《中国医学影像学杂志》2017年11期 　论文类型：期刊论文

【摘要】：目的通过经食管超声心动图(TEE)对儿童法洛四联症(TOF)根治术手术前后进行监测,并与手术前后经胸超声心动图(TTE)进行对比,评价TEE在TOF根治术中的应用价值。资料与方法对行TOF根治术的32例患儿进行回顾性分析。所有患儿术前及术中均运用TEE测量和分析房室腔大小、右心室流出道内径、室间隔周围有无残余分流、肺动脉主干内径、肺动脉瓣口流速及压差、右心室流出道压差,并与手术前后TTE测量值进行比较。结果 32例TOF患儿中,术前TEE对TTE做出修正诊断1例(3%),补充诊断1例(3%)。32例患儿术前TEE与手术结果疾病诊断符合率为100%(32/32)。术中经TEE检查发现手术残余问题7例(21.9%)。术前及术中TEE测量右心室流出道压差与手术前后TTE测量值差异有统计学意义(P0.05)。术中TEE测量右心室流出道的结果较术后TTE测量值降低约28%。术后TEE测量的房室腔大小、右心室流出道内径、肺动脉瓣口流速与术后TTE测量值相关性良好(r=0.75~0.87,P0.05),术中TEE测得右心室流出道压差与术后TTE测量值呈正相关(r=0.518,P0.05)。术中TEE测量的房室腔大小、右心室流出道内径、肺动脉瓣口流速和压差、右心室流出道压差和术后TTE测量值差异均无统计学意义(P0.05)。结论应用TEE在TOF根治术中进行监测对于术前诊断的修正和补充以及术后即刻评估手术疗效具有重要应用价值。
[Abstract]:Objective to monitor the children with tetralogy of Fallot before and after operation by transesophageal echocardiography (TEE), and to compare it with that of transthoracic echocardiography (TTE) before and after operation. To evaluate the application value of TEE in TOF radical operation. Data and methods 32 cases of TOF radical operation were retrospectively analyzed. The size of atrioventricular cavity and the diameter of right ventricular outflow tract were measured and analyzed by TEE before and during operation. There was no residual shunt around the ventricular septum, the diameter of the main pulmonary artery, the velocity and pressure difference of pulmonary valve orifice, the pressure difference of the right ventricular outflow tract, and the results were compared with those measured by TTE before and after operation in 32 patients with TOF. Preoperative TEE was used to correct the diagnosis of TTE in 1 case, and complementary diagnosis was made in 1 case. The coincidence rate between preoperative TEE and surgical results was 100 / 32 / 32. 7 cases of residual problems were found by TEE during operation. Right ventricular flow was measured by TEE before and during operation. There was significant difference between the pressure difference of exit tract and that of TTE before and after operation (P 0.05). The results of right ventricular outflow measured by TEE during operation were about 28% lower than that of TTE. The size of atrioventricular chamber measured by TEE after operation was about 28% lower than that of postoperative TTE. The right ventricular outflow tract diameter, pulmonary valve velocity and postoperative TTE measurements were correlated well. The right ventricular outflow tract pressure difference was positively correlated with postoperative TTE measured by TEE. The size of atrioventricular cavity measured by TEE and the diameter of right ventricular outflow tract were measured during the operation. Pulmonary valve velocity and pressure difference, There was no significant difference in the pressure difference of right ventricular outflow tract and the measurement of TTE after operation (P 0.05). Conclusion the monitoring of TEE in TOF radical operation is of great value in the correction and supplement of preoperative diagnosis and the evaluation of postoperative curative effect immediately after operation.
【作者单位】：湖南省儿童医院超声科;湖南省儿童医院心胸外科;
【分类号】：R540.45;R726.5

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