实时三维经胸超声心动图联合术中经食管超声心动图在二尖瓣病变的临床应用

Study of real-time three-dimensional transthoracic combined intraoperative esophageal echocardiography in the follow-up of mitral valve disease

目的探讨实时三维经胸超声心动图联合术中经食管超声在二尖瓣病变手术患者中的应用。方法回顾性分析明确诊断为二尖瓣瓣膜病并行二尖瓣病变手术患者40例,其中儿童患者7例,成年患者33例,分别于术前及术后3个月测量入组患者的左心房前后径(anteroposterior diameter of left atrium,LAAPD)、左心室射血分数(left ventricular ejection fraction,LVEF)、左心室舒张末期内径(left ventricular end-diastolic diameter,LVEDD)、二尖瓣病变等情况。结果与术前相比,儿童及成年组患者术后3个月的LAAPD、LVEDD均明显减小,且仅成年组患者术后的LVEF值明显增加,差异有统计学意义(P<0.05),术后3个月进行随访时显示,儿童及成年组患者术后二尖瓣返流例数均较术前明显减少,差异有统计学意义(P<0.05),二尖瓣返流量(mitral regurgitation,MR)分级与术式呈正相关。结论实时三维经胸超声心动图联合术中食管超声具有无创、操作简便、省时等优点,在二尖瓣病变的应用中发挥着极其重要的作用,能够在术前准确显示瓣膜病损部位、程度,并指导术式选择。

Objective To explore the application of real-time three-dimensional transthoracic echocardiography combined with intraoperative transesophageal ultrasound in patients with mitral valve disease.Methods Retrospective analysis with mitral valve parallel membrane disease mitral valve lesions(40 cases),of which 7 cases of children patients,33 patients with adult,respectively in the preoperative and postoperative march into the group of patients after the left front diameter(LAAPD),left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF)%,mitral valve lesions,and so on and so forth.Results Compared with the preoperative,and in patients with postoperative children before and after 3 months of left atrium diameter(LAAPD),left ventricular end-diastolic diameter(LVEDD)were significantly decreased,and only in patients with postoperative LVEF value increased significantly,the difference was statistically significant(P<0.05),postoperative 3 months follow-up showed that when the children and the number of cases of postoperative mitral regurgitation in patients with preoperative significantly reduce the difference was statistically significant(P<0.05),MR grade was positively correlated with surgical procedure.Conclusion Real-time three-dimensional transthoracic echocardiography combined with intraoperative esophageal ultrasound has the advantages of non-invasive,simple operation and time-saving,playing an extremely important value in the application of mitral valve disease,and can accurately display the location and degree of valvular disease and guide the selection of operative methods.