经食管及经胸超声心动图对风湿性心脏病左房血栓诊断的对比研究

目的研究多平面经食管超声心动图(TEE)及经胸超声心动图(TTE)对风湿性心脏病左房及左心耳血栓诊断价值比较。方法对临床欲行二尖瓣球囊扩张术及房颤复律的256例风心病患者TTE检查后行TEE检查,对左房血栓(LAT)、左心耳血栓(LAAT)的检出情况进行总结分析。结果TTE:检出血栓者17例,检出率6.64%,血栓位于左房腔内12例,单纯位于左心耳部2例,左房与左心耳部并存3例,有自发云雾状回声者2例。TEE:新增检出血栓者32例,检出率12.5%,血栓位于左房腔内3例,单纯位于左心耳部28例,左房与左心耳部并存1例,有自发云雾状回声者13例。结论TEE对左心耳部血栓的检出率显著高于TTE,特别是新鲜血栓及左房云雾状回声优于TTE。

Left Atrial Thrombi by Detected with Transesophageal and Transthoracic Echocardiography in Rhematic Heart Disease Patients:Comparison Study

Objective Dignosis of left atrial and left atrial appendage(LAT and LAAT) thrombi in rhematic heart disease patients using trasesophageal and transthoracic echocardiography (TEE and TTE).Methods LAT and LAAT were examined and analysed in 256 rhematic heart disease patients who would undergone balloon dilation and cardioversion of atrial fibrillation.Results On TTE:17 patients had thrombi (6.64%) with LAT in 12,LAAT in 2,both in 3,of which 2 with spontaneous echo contrasts.On TEE:other 32 patients also had thrombi (12.5%) with LAT in 3,LAAT in 28,both in 1,of which 13 with spontanecous echo contrast.Conclusions LAAT was found higher on TEE than on TTE,espcially fresh thrombi and spontaneous echo contrast in atrium.