经食道超声心动图监测在心脏瓣膜手术患者麻醉循环管理中的应用价值

Application Value of Transesophageal Echocardiography in the Management of Anesthesia Circulation in Patients Undergoing Heart Valve Surgery

目的将经食道超声心动图(TEE)监测用于心脏瓣膜手术患者麻醉循环管理中,对其应用价值进行观察。方法选取2018年1—6月该院收治的62例行心脏瓣膜手术的患者,以数字随机表法分为观察组(n=31)及参照组(n=31)。参照组行传统监测,观察组行TE监测,对两组监测结果进行观察。结果观察组心脏复跳至CPB停机时间为(25.71±2.14)min,与参照组(29.12±2.68)min相比,明显更短(t=5.536,P=0.000);观察组T1~T3各时段MAP、乳酸值与T0时相比,差异无统计学意义(P>0.05),参照组T1~T3各时段MAP、乳酸值与T0时相比,差异有统计学意义(P<0.05);观察组T1~T3各时段MAP与参照组相比,差异有统计学意义(P<0.05),观察组T0~T3各时段乳酸值与参照组相比,差异有统计学意义(P<0.05)。结论TEE监测在心脏瓣膜手术中应用价值较高,可评估术后即刻效果、指导心内排气及CPB停机,还可维持术中循环稳定,利于保障手术安全及成功性。

Objective To use transesophageal echocardiography(TEE)monitoring in the management of anesthesia in patients with heart valve surgery,and to observe its application value.Methods A total of 62 patients undergoing heart valve surgery in the hospital from January to June 2018 were selected and divided into an observation group(n=31)and a reference group(n=31)by digital random table method.The reference group underwent traditional monitoring.The observation group was monitored by TE,and the monitoring results of the two groups were observed.Results The observation group’s heart relapsing to CPB downtime was(25.71±2.14)min,which was significantly shorter than that of the reference group(29.12±2.68)min(t=5.536,P=0.000);the observation group was MAP in each period from T1 to T3,Lactic acid value compared with T0,the difference was not statistically significant(P>0.05),the reference group T1~T3 each time period MAP,lactate value compared with T0,the difference was statistically significant(P<0.05);observation group Compared with the reference group,the difference in MAP between T1~T3 and the reference group was statistically significant(P<0.05).Compared with the reference group,the lactic acid value of the observation group was statistically significant(P<0.05).Conclusion The application value of TEE monitoring in heart valve surgery is high,which can evaluate the immediate postoperative effect,guide intracardiac exhaust and CPB shutdown,and maintain the stability of intraoperative circulation,which is conducive to ensuring the safety and success of the operation.