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目的评价经食管超声心动图(TEE)对指导小儿先天性心脏病(先心病)外科手术和介入治疗的应用价值及其安全性。方法2000年11月至2005年1月,在上海市复旦大学附属儿科医院心血管中心接受外科开胸手术或经导管介入治疗的先心病患儿中有317例进行了TEE检查,年龄2个月至17岁6个月(平均4.7岁)。采用HP/SONOS2500超声诊断仪,频率5.5～7.5MHz双平面经食管探头,全麻状态下进行。结果与术前经胸超声心动图(TTE)比较,术前TEE检查对诊断作出修正或补充者51例(16.1%),其中因此而修正了手术治疗方案25例(7.9%)。术后TEE检查发现有并发症或残余问题57例(18.0%),其中8例(2.5%)因此立即再次手术。所有病例均未因TEE检查而引起并发症。结论TEE可安全地应用于小儿先心病围术期检查,对术前诊断做出修正或补充,术后可及时发现并发症或残余问题。

The role of transesophageal echocardiography in children with congenital heart disease during perioperative period

Objective To evaluate the utility of transesophageal echocardiography (TEE) for surgical and interventional repairs in children with congenital heart disease (CHD) and its safety as well.Methods 317 patients with CHD underwent TEE examinations at the age of 2 months~17 years and 6 months(mean 4.7 years).HP/SONOS2500 ultrasonic instrument with transesophageal biplane probe of 5.5~7.5MHz was used to perform TEE under general anesthesia.Results Compared with preoperative transthoracic echocardiography(TTE),TEE had new findings or made revision of the diagnoses in 51 cases(16.1%) before operations,which led to the changes of surgical or interventional precedure in 25 cases(7.9%).TEE had found residual problems or evolving situations in 57 cases(18.0%) after operations,which led to a second immediate surgical intervention in 8 cases(2.5%).There were no detectable complications due to TEE in all cases.Conclusion TEE is valuable in providing meaningful preoperative emendations or additions and finding residual problems after operations. The technique is safe in children.