经食管超声心动图在小儿先天性心脏病手术中的应用

目的探讨在小儿先天性心脏病矫正术中经食管超声心动图(TEE)检查的应用价值。方法对需做先天性心脏病矫正术的患儿分别在手术中体外循环前、后做TEE检查,明确术前诊断,修正此前的经胸超声心动图(TTE)误诊及漏诊,即刻评价手术效果及心功能。结果术中TEE检查75例,检查成功73例。修正3例TTE的主要诊断及缺损部位。在心脏复跳后,TEE发现3例室间隔缺损修复术有残余分流,考虑分流较小未予处理(术后6个月内均自愈),3例左心腔内仍有气体存在,再次排气后气体消失。术中TEE检查未出现并发症。结论术中TEE检查能有效地对术前TTE检查确诊,弥补和纠正其遗漏或错误,为术者提供直观的图像及有关的定量信息。是及时评价手术效果的良好佐证。可减少二次开胸手术。它是一种较好的诊断和监测的方法,这种方法已经成为先天性心脏病修复矫正术整体过程中的一部分。

Application of intraoperative transesophageal echocardiography for Pediatric congenital heart diseases

Objective To assess the application of int raoperative transesophageal echocardiography(TEE) for pediatric congenital heart diseases surgery. Methods TEE was performed in children with congenital heart dis eases to confirm or correct primary diagnosis before cardiopulmonary bypass and to evaluate the operative effect immediately after cardiopulmonary bypass. Results Seventy three children with congenital heart diseases receiv ed TEE in cardiac surgery.The diagnosis of 3 children were corrected before ope ning the heart.Operative complications were found in 6 children after cardiopul monary bypass. Conclusions TEE can confirm or correct primary diagnosis before cardiopulmonary bypass and evaluate the operative effect immediately after card iopulmonary bypass,so TEE has important applied value in pediatric cardiace surg ery intraoperatively for congenital heart diseases.