【摘要】 目的探讨经胸超声心动图(TTE)和经食管超声心动图(TEE)在小儿及成人继发孔房间隔缺损(ASD)封堵术前筛查中的应用特点及价值。方法对行介入封堵(A组,136例)及外科微创封堵(B组,63例)治疗的单纯继发孔ASD患者的超声心动图资料及手术结果进行回顾性分析。依据术前是否行TEE检查将研究对象分为4组,A1及B1组患者(>15岁)术前经TTE及TEE筛查,A2及B2组患者(≤15岁)术前仅经TTE筛查。A组患者术中行TTE监护,B组患者术中行TEE监护。结果 ASD缺损径的TTE与TEE测值比较,在A1及B1组差异有统计学意义(P<0.01),在B2组差异无统计学意义(P>0.05);A1、B1、B2组内比较最大缺损径TTE测值与封堵器大小间相关性均低于TEE,组间比较A2及B2组最大缺损径TTE测值与封堵器大小间相关性分别较A1及B1组高。结论 TTE对于低龄小儿患者,可代替TEE成为封堵术前筛选病例的主要方法;TEE对ASD的大小评估优于TTE,在成人患者术前应尽量行TEE作为TTE的补充。更多还原

【Abstract】 Objective To explore the value of transthoracic echocardiography(TTE) and transesophageal echocardiography(TEE) in device closure therapy of secundum atrial septal defect(ASD) in adult and pediatric patients.Methods Between January 2012 and December 2012,136 patients who underwent percutaneous device closure(group A)therapy and 63 patients who underwent minimally invasive intraoperative device closure therapy(group B)were analyzed retrospectively.On the basis of whether preoperative TEE examination was done,the patients of group A and group B were divided into four subgroups:group Al and Bl for the patients with age >15 years who were evaluated by TTE and preoperative TEE,group A2 and B2 for the patients with age <15 years who were evaluated by TTE only before operation.In the operation procedure,all the patients in group A were studied by TTE,All the patients in group B were monitored by intraoperative TEE.Results The parameters of ASD measured by TTE and TEE in group Al,Bl were significantly different(P<0.01),but not significantly different(P>0.05)in group B2.The correlation coefficient of the maximum defect diameter measured by TTE with the size of the occluder was lower than that of TEE within group Al,Bl,B2,the correlation coefficient of TTE in group A2 and B2(younger age group) were higher than groups Al and Bl(adult group).Conclusions For the pediatric patients,TTE may become the main method of screening instead of TEE.In the assessment of the ASD,TEE is better than TTE,preoperative TEE should be performed in adult patients as far as possible to be the supplement of TTE.更多还原