经食管超声心动图多点测量法对风心病外科手术瓣环评估的应用

Clinical value of transesophageal echocardiography with multi-point measurements in rheumatic heart valve surgery

目的探讨经食管超声心动图（transesophageal echocardiography，TEE）多点测量法在风湿性心脏病外科手术前对瓣环检测及评估方面的临床价值。方法选取我院2004年8月至2007年11月间经胸超声心动图及临床确诊为风湿性心脏病拟行外科手术处理的49例患者为研究对象，进行经食管超声心动图常规法和多点测量法检测，并将两种方法与手术测值进行对比分析。结果主动脉瓣组瓣环径常规法与手术符合率90．32％，多点测量法与手术符合率96．78％；二尖瓣组瓣环径常规法与手术符合率63．83％，多点测量法与手术符合率89．36％；三尖瓣组瓣环径常规法与手术符合率62．2％，多点测量法与手术符合率71．11％。结论经食管超声心动图多点测量法在风湿性心脏病外科手术前对瓣环评估有重要的临床价值，在常规法基础上增加多点测量法更能为临床上合理手术提供进一步参考。

Objective To evaluate the clinical value of transesophageal eehoeardiography （TEE）with multi-point in the measurement of valvular annulus diameters before rheumatic heart valve surgery. Methods TEE was performed in 49 patients with clinical diagnosis as rheumatic heart disease before surgical treatment in our hospital from August 2004 to November 2007. TEE detected valvular annulus in the traditional conventional method and the new multi-point measurement. And comparative analysis was made between the two methods and surgical method. Results Of AV group, MV group and TV group, the agreement of conventional method and surgical methods was 90. 32% , 63.83 % and 62. 2% respectively, however, the agreement of multi-point measurement and surgical method was 96.78% ,89. 36% and 71.11%. Conclusion With the cooperation of conventional method and multi-point measurement of TEE is important to assess the clinical value before rheumatic heart valve surgery.