经食道超声心动图在心源性栓塞性卒中的应用

Application of Transesophageal Echocardiography in Cardioembolic Stroke

目的分析在心源性栓塞性卒中患者采取经食道超声心动图的诊断效果。方法对于本院心源性栓塞性卒中患者共计80例,针对同一患者采取经食道超声心动图(TEE)、经胸壁超声心动图(TTE)检查分组,经胸壁超声心动图检查结果为对照组、经食道超声心动图检查结果为观察组,对比心源性栓塞性卒中栓子来源检出率。结果依据不同症状强度,心源性栓塞性卒中病因分为高危性、低危性。高危性栓子来源检出率对比中,观察组扩张型心肌病、风湿性二尖瓣狭窄、感染性心内膜炎、心房黏液瘤检出率与对照组相比无差异(P>0.05);观察组高危性房颤、人工机械瓣膜、主动脉弓粥样硬化斑块的检出率更高(P<0.05)。低危性栓子来源对比中,观察组主动脉瓣钙化性狭窄、二尖瓣瓣环钙化、左心耳自发性显影与对照组相近(P>0.05),观察组卵圆孔未闭、房/室间隔缺损、房间隔膨胀瘤检出率更高(P<0.05)。结论在心源性栓塞性卒中诊断过程中采取经食道超声心动图检查能够及时发现心源性栓子的来源。

Objective To analyze the diagnostic effect of transesophageal echocardiography in patients with cardioembolic stroke.Methods A total of 80 patients with cardioembolic stroke in our hospital were divided into two groups:transesophageal echocardiography(TEE)and transthoracic echocardiography(TTE).The results of transthoracic echocardiography were used as the control group,while the results of transesophageal echocardiography were used as the observation group.The detection rate of embolic origin in cardioembolic stroke was compared.Results According to different symptom intensities,the etiology of cardioembolic stroke is classified as high-risk and low-risk.In the comparison of the detection rates of high-risk embolic sources,there was no difference in the detection rates of dilated cardiomyopathy,rheumatic mitral stenosis,infective endocarditis,and atrial mucinous tumors between the observation group and the control group(P>0.05);The detection rate of high-risk atrial fibrillation,artificial mechanical valve and aortic arch atherosclerotic plaque in the observation group was higher(P<0.05).In the comparison of low-risk embolic sources,the observation group had similar levels of calcific stenosis of the aortic valve,calcification of the mitral valve annulus,and spontaneous left atrial appendage development to the control group(P>0.05),while the observation group had higher detection rates of patent foramen ovale,atrial/ventricular septal defect,and atrial septal dilation tumor(P<0.05).Conclusion In the diagnosis of cardioembolic stroke,transesophageal echocardiography can timely detect the source of cardioembolic emboli.