经食管实时三维超声心动图在心脏外科手术中的临床应用.docVIP

经食管实时三维超声心动图在心脏外科手术中的临床应用 东阳市人民医院 陆献大 【摘要】 目的 探讨经食管实时三维超声心动图(RT-3D-TEE)在心脏外科手术中的临床应用价值。方法 选择40例接受心脏外科手术的患者进行经食管实时三维超声心动图术中监测，其中风湿性心脏病二尖瓣病变17例（其中1例合并房间隔缺损），风湿性心脏病二尖瓣主动脉瓣联合病变 3 例，风湿性心脏病主动脉瓣病变3例，二尖瓣脱垂3例，室间隔缺损 4例（其中1例室间隔膜部瘤形成），房间隔缺损10 例（其中2例合并Ebstein畸形）。结果RT-3D-TEE能够实时直观地显示经食管角度观察的立体解剖图像，清晰地显示心脏瓣膜及其病变以及房间隔缺损的部位和范围，术后可即刻通过三维图像更直观地评价手术效果。结论 RT-3D-TEE可同步显示三维立体影像，图像质量好，可方便应用于心脏术中监测，为心脏手术术前决策及术后效果评价提供重要的信息，在心脏外科手术中具有重要的临床应用价值。 【关键词】 经食管超声心动描记术 实时三维 心脏外科手术 术中监测 Clinical Application of the Real-Time Three-dimensional Transesophageal Echocardiography in Cardiac Surgery 【Abstract】 Objective To investigate the clinical value of Real-Time Three-dimensional Transesophageal Echocardiography (RT-3D-TEE) in cardiac surgery. Methods Using RT-3D-TEE intraoperative monitoring were applied for 40 cases of cardiac surgery patients including 17 cases of rheumatic mitral valvular disease (one case combined with atrial septal defect), 3 cases of rheumatic combined mitral and aortic valve disease, 3 cases of rheumatic aortic valve disease, 3 cases of mitral valve prolapse, 4 cases of ventricular septal defect (one case with tumor of membranous part of interventricular septum), and 10 cases of atrial septal defect (two cases combined with Ebsteins anomaly). Results RT-3D-TEE proved to show a visual display of 3D anatomical images from the transesophageal view in real-time, and clearly dispaly the cardiac valves and cardiac lesions as well as the location and area of the atrial septal defect. Besides, the effects of the surgery could be evaluated visually by 3D images immediately after the operation. Conclusion RT-3D-TEE synchronously displayed real-time 3D images with excellent quality conductive to the intraoperative monitoring of cardiac surgery, which offered important informations for the preoperative decision and postoperative evaluation of the cardiac surgeries. Consequently it had significant clinical application value for the cardiac surgeries. 【Keywords】 Transesophageal ultras