三维经食管超声心动图导航左心室室壁瘤手术中的作用分析简

目的室壁瘤切除术中应用三维经食管超声心动图（3D-TEE）导航，定量分析手术前后室壁瘤患者左心室功能，探讨对患者远期愈后的作用。方法64例行左心室室壁瘤切除手术患者，分2组，每组32例。行3D-TEE为试验组，其中男性29例.女性3例：年龄46～76岁，平均年龄59.9岁。对照组术中未行3D-TEE检查，其中男性29例，女性3例；年龄38。79岁，平均年龄60.0岁。在患者手术前3d内、术后1年分别行3D-TTE检查，对照分析同期行室壁瘤切除手术患者心功能，并记录分析两组患者手术时间、术后辅助治疗、术后不良事件发生及治疗前后左心室结构与功能改善的情况。结果术后试验组左心室射血分数为（45.88±6.60）％，每搏量（49.95±7.18）mL，心指数（2.17±0.44）IJ（min·m^2）；对照组左心室射血分数为（37.88±6.82）％，每搏量（40.54±10.12）mL，心指数（1.68±0.38）I／（min·m^2）；试验组明显高于对照组，二者差异有统计学意义（P〈0.05）。两组左心室舒张末容积差异无统计学意义（P〉0.05）.但试验组左心室收缩末容积明显低于对照组.二者差异有统计学意义（P〈0.05）。两组患者手术时间相差无统计学意义。结论术中应用3D-TEE检查能够安全、便捷地评价室壁瘤形成患者的左心室。在术中应用3D-TEE为导航.更利于外科医生的判断和处理.对患者的远期效果应该更好。

Analysis of three-dimensional transesophageal echocardiography navigation in left ventricular aneurysm surgery

Objective To investigate three-dimensional transesophageal echocardiography（3D- TEE） navigation in aneurysm resection, quantitative analysis of left ventricular function in myocardial infaretion（MI） patients before and after surgery, and study long-term efficacy of MI patients. Methods A total of 64 patients with left ventricular aneurysm resection were randomly divided into 2 groups： experimental group（n = 32, 29 males and 3 females, aged 46 - 76 years old with mean age of 59.9） and control group（n = 32, 29 males and 3 females, aged 38 - 79 years old with mean age of 60.0）. The experimental group were performed 3D-TEE three days before surgery and 1 year after surgery, the concomitant aneurysm surgery cardiac function of MI patients were compared. The operation time, postoperative adjuvant therapy, postoperative adverse events and left ventricular structure and function before and after treatment between 2 groups were recorded and analyzed. Results After operation, left ventrieular ejection fraction, stroke volume and cardiac index of experimental group were （45.88 ± 6.60） %, （49.95 ± 7.18） mL and （2.17 ± 0.44） U（min·m^2）, respectively; while the control group were （37.88 ± 6.82） %, （40.54 ± 10.12） mL and （1.68 ± 0.38） U（min·m^2）, respectively; results of experimental group were significantly higher than those of control group, the differences had dramatically statistic signifieanee（P 〈 0.05）. Left ventrieular end-diastolic volume of 2 groups showed no significant difference（P 〉 0.05）. Left ventrieular end-systolic volume in experimental group was significantly lower than that of control group, and the difference was statistically signifieant（P 〈 0.05）. The operation time of 2 groups had no statistic significance. Conclusion It is demonstrated that the 3D-TEE examination could safely and easily evaluate patients with ventricular aneurysm, which is more favorable for plastic surgeons＇ judgment and treatment, and the long-term effects should be better.