本文選題：法洛四聯(lián)癥　切入點(diǎn)：超聲心動(dòng)描記術(shù)　出處：《中國(guó)醫(yī)學(xué)影像學(xué)雜志》2017年11期 　論文類型：期刊論文

【摘要】：目的通過(guò)經(jīng)食管超聲心動(dòng)圖(TEE)對(duì)兒童法洛四聯(lián)癥(TOF)根治術(shù)手術(shù)前后進(jìn)行監(jiān)測(cè),并與手術(shù)前后經(jīng)胸超聲心動(dòng)圖(TTE)進(jìn)行對(duì)比,評(píng)價(jià)TEE在TOF根治術(shù)中的應(yīng)用價(jià)值。資料與方法對(duì)行TOF根治術(shù)的32例患兒進(jìn)行回顧性分析。所有患兒術(shù)前及術(shù)中均運(yùn)用TEE測(cè)量和分析房室腔大小、右心室流出道內(nèi)徑、室間隔周圍有無(wú)殘余分流、肺動(dòng)脈主干內(nèi)徑、肺動(dòng)脈瓣口流速及壓差、右心室流出道壓差,并與手術(shù)前后TTE測(cè)量值進(jìn)行比較。結(jié)果 32例TOF患兒中,術(shù)前TEE對(duì)TTE做出修正診斷1例(3%),補(bǔ)充診斷1例(3%)。32例患兒術(shù)前TEE與手術(shù)結(jié)果疾病診斷符合率為100%(32/32)。術(shù)中經(jīng)TEE檢查發(fā)現(xiàn)手術(shù)殘余問(wèn)題7例(21.9%)。術(shù)前及術(shù)中TEE測(cè)量右心室流出道壓差與手術(shù)前后TTE測(cè)量值差異有統(tǒng)計(jì)學(xué)意義(P0.05)。術(shù)中TEE測(cè)量右心室流出道的結(jié)果較術(shù)后TTE測(cè)量值降低約28%。術(shù)后TEE測(cè)量的房室腔大小、右心室流出道內(nèi)徑、肺動(dòng)脈瓣口流速與術(shù)后TTE測(cè)量值相關(guān)性良好(r=0.75~0.87,P0.05),術(shù)中TEE測(cè)得右心室流出道壓差與術(shù)后TTE測(cè)量值呈正相關(guān)(r=0.518,P0.05)。術(shù)中TEE測(cè)量的房室腔大小、右心室流出道內(nèi)徑、肺動(dòng)脈瓣口流速和壓差、右心室流出道壓差和術(shù)后TTE測(cè)量值差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論應(yīng)用TEE在TOF根治術(shù)中進(jìn)行監(jiān)測(cè)對(duì)于術(shù)前診斷的修正和補(bǔ)充以及術(shù)后即刻評(píng)估手術(shù)療效具有重要應(yīng)用價(jià)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.
【作者單位】： 湖南省兒童醫(yī)院超聲科;湖南省兒童醫(yī)院心胸外科;
【分類號(hào)】：R540.45;R726.5

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