经食道超声心动图(TEE)在心脏瓣膜手术中的应用

摘要 目的：评价经食管超声心动图(TEE)在心脏瓣膜手术中的临床应用价值。方法：对247例心脏瓣膜手术患者行TEE监测，与术前诊断比较、比较200例二尖瓣置换病人换瓣前后瓣膜返流并观察体外停机前后气体出现情况。结果：（1）补充诊断29例(占11.74％)，更正诊断20例(占8.09％)。（2）200例二尖瓣置换病人术后返流量远比换瓣前返流量少(P<0.01)，有5例(2.5%）返流量>3级，及时在体外循环下重新进行瓣周漏修补术，效果良好。（3）247例病人中有l88例(76.11％)左房发现微量气体。结论：TEE在心脏手术麻醉中的应用，不仅补充和更正术前诊断而且能即刻评估术后瓣膜状况及功能，监测左心气体。

The application of transesophageal echocardiography to patients undergoing cardiac valve surgery

Abstract Objective：To assess the clinic value of transesophageal echocardiography(TEE)during cardiac valve surgery．Method：To monitor 247 patients undergoing cardiac valve surgery in order to compare the results with pre-operative conditions and observe retained air.Result：(1)Additional defect was found in 29 cases(11.74％).Pre-operativediagnosis was found to be wrong by TEE in 20 cases(8.09％).(2)There was significant improvement in the mitral regurgitation grade after mitral replacement(P<0.01).Significant residual mitral regurgitaton(＞grade3) that necessitated immediately further surgery was identified in 5(2.5%）patients.The results for re-do were satisfactory.(3)The left atrial gaswas detected in 188(76.11%) patients among 247 cases.Conclusion:Intra-operative transesophageal echocardiography is useful in supplementing pre-operative diagnosises and assessing immediate operative results or identifying retained air.