经胸超声心动图在心血管病介入性治疗的应用

Application of Echocardiography in Interventional Cardiology

目的：探讨超声心动图引导介入性治疗心血管病的可行性。方法：在彩色超声心动图仪和大型Ｘ线心血管造影仪同时监测下，摸索超声心动图监测引导动脉导管栓堵、二尖瓣和肺动脉瓣狭窄球囊扩张术的最佳观察方法。结果：引导介入性治疗患者５１例。结果表明在二尖瓣狭窄患者中，可正确引导心房间隔穿刺，在二尖瓣及肺动脉瓣狭窄球囊扩张术中，可引导球囊导管的走向、所在部位、扩张程度。在动脉导管栓堵术中，可监测引导栓堵物置入部位，确定其嵌顿的牢固性。术中可对治疗效果进行即时判定。结论：经胸超声心动图引导介入性治疗心血管病具有Ｘ线所不能起到的作用，并且术中可即时判定治疗效果，有其独特优点。

Objective:To study the possibility of performing interventional procedures to treat cardiovascular diseases under the monitoring of echocardiography(Echo). Methods:Under the monitoring of colour Echo and X ray,percutaneous transcatheter closure of patent ductus arteriosus,mitral and pulmonary valvuloplasty were performed.The best section and observation of Echo were studied.The immediate post operative results of interventional procedures were determined by Echo,combined with clinical and angiographic studies. Results:Interventional procedures were performed on 51 patients with cardiovascular diseases.The catheter engaged into cardiac chamber and great vessel could be guided and monitored by Echo.Under the Echo guidance the puncture of atrial septum could be performed accurately,and the position,direction and dilatation state of balloon catheter could be determined clearly during the procedure of mitral and pulmonary valvuloplasty;and the situation of embolism confirmed during transcatheter closure of patent ductus arteriosus.The result of procedure could be determined by Echo immediately after operation. Conclusions:Under the guidance of transthoracic Echo,interventional procedures for cardiovascular diseases n be performed with an effect not achievable by X ray,and the therapeutic effect can be determined immediately after the procedure.The method is unique and helpful in interventional cardiology.