二维及三维经食管超声心动图在心脏外科手术中的对比研究

目的应用三维经食管超声心动图（three-dimensional transesophageal echocardiography,3D-TEE）全程监测25例心脏手术,术中与二维经食管超声心动图（two-dimensional transesophageal echocardiography,2D-TEE）及手术结果比较,探讨3D-TEE在心脏手术中应用价值。方法研究对象为四川大学华西医院心脏外科手术患者25例。瓣膜病变13例（风湿性心脏病8例,二尖瓣脱垂3例,感染性心内膜炎2例）;先心病10例（房间隔缺损5例,其中1例行外科微创封堵,室间隔缺损3,主动脉窦瘤2例）;心脏肿瘤2例。结果25例患者均获得满意的三维图像,心内结构和病变的显示3D-TEE较2D-TEE更形象、更直观、与毗邻结构的解剖关系更清晰和易于辨认,对瓣周漏、片周漏等更能准确定量,能检出二维超声未能发现的问题,与手术结果更加接近。结论在瓣膜病变、先心病和心脏肿瘤术中3D-TEE较2D-TEE更易提供丰富的形态学信息,有助于治疗措施的选择,更为外科医师理解和接受。

Comparison Study of Three-dimensional and Two-dimensional Transesophageal Echocardiography during Cardiac Operations

Objective To compare three-dimensional and two-dimensional transesophageal echocardiography during cardiac operations.Methods Twenty - five patients with different cardiac diseases were selected in this study,including 13 cases with valvular heart diseases (8 cases with rheumatic heart disease,3 cases with mitral valve prolapse,2 cases with infective endocarditis);10 cases with congenital heart diseases(5 cases with atrial septal defect,3 cases with ventricualr septal defect,2 cases with aortic sinus aneurysm);2 cases with cardiac tumor.Results 3D-TEE images were satisfied in nearly all cases.Compared with 2D-TEE,The location,morphology and relation with neighboring structures of cardiac space occupying lesions could be displayed more intuitively on 3D-TEE.3D-TEE could reveal some cardiac structures and their spatial relationships,which 2D-TEE was unable to show.Conclusions 3D-TEE may provide more abundant morphologic information of cardiac space occupying lesions and is of great benefit for treatment planning during cardiac operations.