食道超声心动图联合肺动脉导管对心脏瓣膜疾病合并冠心病患者手术效果的影响

Influence of esophageal echocardiography combined with pulmonary artery catheter on surgery effect of the patients with heart valve disease complicated with coronary heart disease

目的探讨食道超声心动图联合肺动脉导管对心脏瓣膜病合并冠心病患者手术效果的影响。方法选取2012年1月-2014年1月在我院行手术治疗的30例心脏瓣膜病合并冠心病患者作为对照组，选取2014年2月-2015年1月在我院行手术治疗的30例心脏瓣膜病合并冠心病患者作为试验组。试验组术前行食道超声，放置漂浮导管，联合评价瓣膜及心脏功能。对照组仅有术前的经胸超声心动图，无其他特殊监测手段。比较两组术前、术中、术后的循环波动以及ICU停留时间和术后复查情况。结果试验组术中、术后的平均动脉压（MAP）差值显著低于对照组，差异有统计学意义（P〈0．05）。试验组术后的ICU停留时间显著短于对照组，差异有统计学意义（P〈0．05）。试验组的转归率为96．7％，高于对照组的80．0％，差异有统计学意义（P〈0．05）。结论食道超声联合肺动脉导管能够加强瓣膜病合并冠心病患者的循环管理，减少术后ICU停留时间，有利于患者转归。

Objective To explore the influence of esophageal echocardiography combined with pulmonary artery catheter on surgery effect of the patients with heart valve disease complicated with coronary heart disease.Methods 30 patients with heart valve disease complicated with coronary heart disease underwent surgery in our hospital from January 2012 to January 2014 were selected as the control group,30 patients with heart valve disease complicated with coronary heart disease underwent surgery in our hospital from Februry 2014 to January 2015 were selected as the experimental group. The experimental group was given esophageal ultrasound before surgery,the floating catheter was placed,and the valve and cardiac function were evaluated.The control group was given preoperative echocardiography,no other special moni- toring methods were given.Preoperative,intraoperative,postoperative circulation fluctuation and ICU residence time and postoperative review were compared between the two groups.Results The difference of mean arterial pressure （MAP） in the experimental group was lower than that in the control group,with significant difference （P〈0.05）.The postoperative ICU residence time in the experimental group was shorter than that in the control group,with significant difference （P〈 0.05）.The transformation rate of the experimental group was 96.7%,which was higher than 80.0% of the control group, with significant difference （P〈0.05）.Conclusion Esophageal ultrasound combined with pulmonary artery catheter can enhance the circulation management of patients with heart valve disease complicated with coronary heart disease,reduce the postoperative ICU residence time,which is beneficial to the patient＇s prognosis.