| 王燕,王浩,朱振辉,李永青,逄坤静,孟红.经胸及术中经食管超声心动图在主动脉夹层诊疗中的应用[J].中国医学影像技术,2013,29(10):1621~1624 |
| 经胸及术中经食管超声心动图在主动脉夹层诊疗中的应用 |
| Transthoracic and intraoperative transesophageal echocardiography in diagnosis and assessment of aortic dissection |
| 投稿时间：2013-04-07 修订日期：2013-07-13 |
| DOI： |
| 中文关键词: 超声心动描记术 超声心动描记术,经食管 动脉瘤,夹层 |
| 英文关键词:Echocardiography Echocardiography,transesophageal Aneurysm,dissecting |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨TTE及术中经食管超声心动图(IOTEE)在主动脉夹层(AD)术前诊断、术中监测及术后随访中的应用价值.方法 收集经手术证实的56例AD患者的超声心动图资料, 均于手术前后接受TTE和IOTEE检查.结果 56例AD中,DeBakeyⅠ型36例,Ⅱ型12例,Ⅲ型8例.TTE诊断AD敏感度为89.29%(50/56),IOTEE为100%(56/56);IOTEE诊断AD分型、假腔内血栓形成、内膜撕脱、破口位置优于TTE.IOTEE于术后即刻评价主动脉瓣功能,2例接受带瓣人工血管主动脉根部替换术者出现瓣周漏,再次修补后无明显瓣周漏,余瓣膜功能正常;术后3天至1个月 TTE复查显示55例瓣膜及人工血管功能正常,1例左冠状动脉吻合口撕裂,再次行冠状动脉吻合术后恢复正常.结论 TTE在初步诊断AD及术后随访中具有重要作用;IOTEE对决定AD手术方案和即刻评价手术效果具有独特价值. |
| 英文摘要: |
| Objective To explore the value of TTE and intraoperative transesophageal echocardiography (IOTEE) in preoperative diagnosis, intraoperative monitoring and postoperative follow-up of aortic dissection (AD). Methods A total of 56 patients with AD underwent TTE and IOTEE before and after surgical operation. Results There were 36 cases of DeBakey I type AD, 12 of DeBakey Ⅱ type and 8 of DeBakey Ⅲ type AD.The diagnostic sensitivity of TTE was 89.29% (50/56), while of IOTEE was 100% (56/56). IOTEE was superior to TTE in typing AD and assessment of thrombosis in the false lumen, intimal tearing and location of the rupture. Paravalvular leaks were detected in 2 cases receiving Bentall procedures by IOTEE immediately after operation and were repaired again successfully. The function of aortic valves in the other cases were normal. Three days to 1 month after operation, TTE showed that the function of aortic valves and artificial vessels were normal in 55 cases and the anastomosis of left coronary was tore in 1 case which received anastomosis again and recovered. Conclusion TTE plays an important role in diagnosis and postoperative follow-up of AD, and IOTEE does an important job in selection of surgical method and assessment of operation effect immediately. |
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