经食管超声心动图检查的重症并发症

Significant Complication Caused by transeasophageal echocardiography

目的探讨经食管超声心动图(TEE)检查中的重症并发症。方法回顾分析我院13年来,门诊和住院经食管超声心动图检查的855例患者,其中单平面TEE417例,多平面438例。结果TEE引起重症并发症3例,可疑1例。其中严重心绞痛和呼吸困难各1例,1例左房黏液瘤患者检查中发生急性脑栓塞。1例可疑病例为风湿性心脏病,TEE检出左房及左心耳血栓,检查后24h发生脑栓塞。结论本组病例TEE的重症并发症发病率为0.35%。笔者建议将心房黏液瘤及心房血栓等心脏占位病变,列为TEE的相对适应证。如经胸超声心动图(TTE)检查能确诊时,应慎行TEE检查。TTE检出有穗状分叶、蒂长、活动度大的黏液瘤应为TEE禁忌证。

Objective To explore the significant complication in vivo with transeasophageal echocardiography （TEE） , Methods We have reviewed and analysed 885 patients by TEE in the past 13 years, including 417 patients with Monoplane TEE and 438 patients with Omniplane TEE, Results TEE causes 1 dubitable case and significant complication 3 cases including 1 case with serious angina pectoris, 1 case with dyspnea and acute cerebral embolism, and 1 case with left atrium myxoma. The dubitable case is a patient with rheumatic heart disease and thrembosis is found in left atrium and left atrial appendage. After 24 hours of TEE examination cerebral embolism come about in this dukitalle patient. Conclusions The incidence of significant complication by TEE is 0. 35~ in our study, We think that cardiac occupying lesion and well an atrium myxoma and atial thromei in relative indications of TEE. So we suggeat that if one patient can be diagnosed by transthoracic echocardiography （TTE）, the TEE examination needn＇t be performed any mere and that if the myxoma found by TTE is fringy foliage, long pedicel and easily movable, it should be the contraindication of TEE.