经食管超声心动图在心脏手术心肺转流停机困难中的应用进展

Application progress of transesophageal echocardiography in cardiac surgery with difficult shutdown of cardiopulmonary bypass

由于结构性或功能性心脏异常、血管麻痹综合征或心室功能障碍,心脏外科患者会出现心肺转流(CPB)停机困难。在这些情况下,需要迅速做出决策才能成功停机。自上世纪90年代中期以来,经食管超声心动图(TEE)为评估手术的完整性、识别异常循环状况和指导外科决策提供了帮助。本文分别从心室功能障碍、心脏结构异常、心脏通道功能异常、血管麻痹综合征四个方面分别阐述TEE指导CPB停机困难的应用进展。

Due to abnormal structural or functional heart,vasoplegic syndrome,or ventricular dysfunction,it is difficult for many cardiac surgery patients to separate cardiopulmonary bypass(CPB).In these cases,decisions need to be made quickly to take off the cardiopulmonary bypass successfully.Since the mid-1990s,transesophageal echocardiography(TEE)has provided an opportunity to assess the integrity of surgery,identify abnormal circulatory conditions,and guide surgical decisions.The purpose of this review is to provide TEE applications progress related to the difficulty of CPB shutdown in the four aspects of ventricular dysfunction,structural abnormalities of the heart,abnormal channel function,and vasoplegic syndrome.