经食管超声心动图在肥厚型梗阻性心肌病手术中的应用

The impact of transesophageal echocardiography on anesthesia management and surgery for left ventricular outflow tract obstruction patients

目的:对比应用经食管超声心动图(TEE)对患者麻醉和手术转归的影响,阐述TEE在肥厚型梗阻性心肌病左心室流出道疏通术中的作用。方法:回顾性调查31例成人肥厚型梗阻性心肌病左心室流出道疏通术患者,分为GTEE和Gn2组,比较手术后2组患者左心室流出道压差、术后转归和并发症。结果:2组的体外循环时间和主动脉阻断时间无差异,GTEE组术后左心室流出道压差[(26±10)mmHg,1mmHg=0.133kPa]明显低于Gn组[(59±28)mmHg,P<0.01];GTEE组术中并发症和术后转归好于Gn组。结论:术中TEE对麻醉监测和手术处理有积极的指导意义。

Objective： This study was designed to delineate the utility and results of intraoperative transesophageal echoeardiography （TEE） in the evaluation of patients undergoing left ventricular outflow tract （LVOT） obstruction surgery. Method：31 cases of LVOT obstruction surgery were studied retrospectively. Patients were divided into TEE group（ GTEE ）and group without using TEE（ Gn）. Postoperative left ventricular outflow tract pressure gradient, complications and outcome parameters were investigated and compared between two groups. Result： There were no differences between groups in cardiopulmonary bypass times and aorta occlusion times. LVOT pressure gradient of GTEE [（26 ± 10） mmHg] was significantly lower than that of Gn group[（59 ± 28） mmHg, P 〈 0.01]. Complication and outcome＇parameters in GTEE were showed better than that in Gn group as well. Conclusion： Intraoperative TEE has positive impact on the management of anesthesia and surgery for LVOT obstruction patients.