经食管超声心动图右心声学造影与对比增强TCD检查在检测隐源性脑卒中患者右向左分流的效果比较

Comparison of transesophageal echocardiography test and compare contrast TCD test in detection of right-left shunt in patients with cryptogenic stroke

目的比较经食管超声心动图右心声学造影与对比增强TCD检查在检测隐源性脑卒中患者右向左分流的效果。方法选取2016年9月至2017年9月佛山市第一人民医院收治的隐源性脑卒中患者82例,所有患者均进行经食管超声心动图右心声学造影和对比增强TCD检查。对比两种检查方法对于隐源性脑卒中患者右向左分流的检出率及半定量分流分级程度。结果对比增强TCD对右向左分流的检出率[58. 5%(48/82)]显著高于经食管超声心动图右心声学造影[30. 2%(25/82)](P <0. 05)。对比增强TCD对右向左分流的半定量分级明显高于经食管超声心动图右心声学造影(均P <0. 05)。经食管超声心动图右心声学造影后出现吞咽疼痛3例,食管穿孔2例,声音麻痹3例,血压异常5例,合计并发症发生率为15. 9%(13/82),而对比增强TCD后未见相关并发症。结论相对于经食管超声心动图右心声学造影技术,对比增强TCD检查对隐源性脑卒中右向左分流检出率更高,半定量分流程度更高,具有更广阔的应用空间。

Objective To compare the effect of transesophageal echocardiography test and compare contrast TCD test in detection of right-left shunt in patients with cryptogenic stroke. Methods Eighty-two patients with cryptogenic stroke from September 2016 to September 2017 in the First People＇s Hospital of Foshan were selected, and all of the patients underwent transesophageal echocardiography and compare contrast TCD examination. The rate of right-left shunt detection and the degree of semi-quantitative grading between the two methods were compared in patients with eryptogenic stroke. Results The rate of right-left shunt detection of compare contrast TCD [58.5% （48/82） ] was significantly higher than that of transesophageal echoeardiography [ 30.2% （25/82） ] （ P 〈 0. 05 ）. The degree of semi-quantitative grading of compare contrast TCD was significantly higher than that of transesophageal eehocardiography （ all P 〈 0. 05 ）. There were 3 cases of swallowing pain, 2 cases of esophageal perforation, 3 cases of vocal paralysis, and 5 cases of abnormal blood pressure after transesophageal eehoeardiography, and the total rate of complications was 15.9% （13/82）. There was no related complications after compare contrast TCD. Conclusions Compared with transesophageal echoeardiography, the rate of right-left shunt detection and the degree of semi- quantitative grading of compare contrast TCD are higher. Compare contrast TCD has a wider application space.