经食管超声心动图术中实时监测指导微创室间隔缺损封堵术的价值研究

Value research of real-time monitoring of Transesophageal echocardiography in guiding minimally invasive ventricular septal defect closure

目的探讨经食管超声心动图(TEE)对微创室间隔缺损(VSD)封堵术的临床价值。方法 60例VSD封堵术患儿,对患儿术中行TEE观察与指导。随访患儿术后1周、1个月及1年的封堵效果,分析封堵器型号大小与术中TEE监测VSD大小的相关性。结果术后1周、1个月封堵成功率为100.0%,无残余分流、无明显主动脉瓣及房室瓣返流;术后1年封堵成功率为96.7%,其中残余分流1例,主动脉瓣/房室瓣返流1例。TEE监测VSD大小与封堵器型号大小呈正相关(r=0.76,P<0.05)。结论 TEE监测VSD封堵术,对于VSD术前的评估、封堵器型号大小选择具有准确可靠的指导意义,对VSD封堵术后近、远期均具有较好的效果。

Objective To investigate the clinical value of transesophageal echocardiography（TEE） in minimally invasive ventricular septal defect（VSD） closure. Methods A total of 60 children with VSD closure received TEE observation and guidance during surgery. The closure effect was followed up 1 week, 1 month and 1 year after surgery, and the correlation between the size of blockage and the size of VSD measured by TEE was analyzed. Results The success rate of blocking at 1 week and 1 month after surgery were 100.0%, no residual shunt, no obvious aortic valve and atrioventricular regurgitation, and the successful rate of blocking was 96.7% after 1 year, of which 1 case was residual shunt and 1 case of aortic valve/atrioventricular regurgitation. TEE monitoring VSD size was positively correlated with the size of blockage type（r=0.76, P〈0.05）. Conclusion The TEE monitoring of VSD closure has an accurate and reliable guiding significance for the preoperative evaluation of VSD and the size of blockage type. It has good effects on the short and long term after the VSD closure.