经食管超声心动图分析左心耳内部形态结构对左心耳封堵术的指导价值-《中国医学物理学杂志》

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Title:: Guiding value of transesophageal echocardiography analysis on the internal morphological structure of left atrial appendage in left atrial appendage occlusion

文章编号:: 1005-202X（2021）11-1377-04

作者:: 张双1; 王仲华2; 侯玉桃3; 1.郴州市第一人民医院（南华大学附属郴州医院）超声医学中心，湖南郴州 423000； 2.郴州市第一人民医院（南华大学附属郴州医院）心血管内科，湖南郴州 423000； 3.湘南学院附属医院全科医学科，湖南郴州 423000

Author(s):: ZHANG Shuang1; WANG Zhonghua2; HOU Yutao3; 1. Ultrasonic Medical Center, Chenzhou No.1 Peoples Hospital (Chenzhou Hospital Affiliated to Nanhua University), Chenzhou 423000, China 2. Department of Cardiovascular Medicine, Chenzhou No.1 Peoples Hospital (Chenzhou Hospital Affiliated to Nanhua University), Chenzhou 423000, China 3. General Practice, Affiliated Hospital of Xiangnan University, Chenzhou 423000, China

关键词:: 经食管超声心动图; 左心耳; 形态结构; 左心耳封堵术

Keywords:: Keywords: transesophageal echocardiography left atrial appendage morphological structure left atrial appendage occlusion

分类号:: R445.1；R654.2

DOI:: DOI:10.3969/j.issn.1005-202X.2021.11.011

文献标志码:: A

摘要:: 目的：探讨经食管超声心动图（TEE）分析左心耳内部形态结构对左心耳封堵术的指导价值。方法：选取行左心耳封堵术患者110例，术前均给予TEE检查，分析左心耳开口最大径、梳状肌至开口距离等参数。结果：110例患者左心耳封堵术均成功，出现残余分流19例，无残余分流91例；手术时间17~80 min，平均手术时间（45.49±13.30） min；辐射量560~2 100 mGy，平均辐射量（980.50±112.40） mGy；曝光时间520~1 950 s，平均曝光时间（890.50±120.40） s；ACP封堵器尺寸18~33 mm，平均（25.50±2.50） mm；TEE所测左心耳开口最大径为（23.12±2.24）mm，小于ACP封堵器尺寸（P<0.05）；TEE所测左心耳开口最大径与ACP封堵器尺寸呈正相关（r=0.426, P<0.05）；手术时间<45 min和≥45 min患者左心耳开口最大径、左心耳深度及开口与深度比值比差异无统计学意义（P>0.05）；手术时间<45 min患者梳状肌到开口距离为（16.60±3.22） mm，明显大于手术时间≥45 min患者（P<0.05）；梳状肌到开口距离与手术时间呈负相关（r=-0.524, P<0.05）。结论：TEE分析左心耳内部形态结构对左心耳封堵术有一定指导价值，值得临床使用。

Abstract:: Abstract: Objective To investigate the value of transesophageal echocardiography (TEE) analysis on left atrial appendage in guiding left atrial appendage occlusion. Methods A total of 110 patients scheduled for left atrial appendage occlusion were enrolled in the study. All patients were given TEE examination before operation, and the parameters such as the maximum diameter of left atrial appendage opening and the distance from pectinate muscle to the opening were analyzed. Results The left atrial appendage was successfully occluded in 110 patients, and there were 19 cases of residual shunt and 91 cases of no residual shunt. The operation lasted for 17-80 min, with an average of (45.49±13.30) min. The radiation dose was 560-2 100 mGy, with an average of (980.50±112.40) mGy, and the exposure duration was 520-1 950 s, with an average of (890.50±120.40) s. The maximum diameter of left atrial appendage opening measured by TEE was (23.12±2.24) mm, less than the size of ACP which was 18-33 mm, with an average of (25.50±2.50) mm (P<0.05), and the maximum diameter of left atrial appendage opening measured by TEE was positively correlated with the size of ACP (r=0.426, P<0.05). No statistically significant difference was found in the maximum diameter of left atrial appendage opening, the depth of left atrial appendage and their ratio between patients whose operation duration <45 min and ≥45 min (P>0.05). The distance from pectinate muscle to the opening was (16.60±3.22) mm in patients whose operation duration <45 min, which was significantly longer than that in patients whose operation duration ≥45 min (P<0.05). The distance from pectinate muscle to the opening was negatively correlated with operation duration (r=-0.524, P<0.05). Conclusion TEE analysis on the internal morphological structure of left atrial appendage has certain guiding value for left atrial appendage occlusion, worthy of clinical application.

《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

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