摘要
目的:探讨经食道超声心动图评估手术室中心脏不停跳心包剥脱术前、术后左心室舒张功能变化的价值。方法:选取2017年5月至2020年11月本院收治的30例缩窄性心包炎在全身麻醉下行心包剥脱术患者。分别在心包剥脱术前、术后于食道中段四腔心切面、食道中段左心室长轴切面测量二尖瓣血流频谱舒张早期峰值速度(E)、舒张晚期峰值速度(A)、组织多普勒二尖瓣瓣环舒张早期峰值速度(e')、晚期峰值速度(a')、等容舒张时间(IVRT)、E/A比值和E/e'比值。结果:与术前比较,心包剥脱术后E([0.59±0.81)cm/s vs(.0.77±0.09)cm/s]、E/A比值(2.01±0.46 vs.2.76±0.77)、E/e'比值(7.65±1.32 vs.9.16±1.43)及IVRT[(95.21±2.75)ms vs.(100.44±2.12)ms]均降低(P均<0.01);心包剥脱术后A峰差异无统计学意义(P>0.05)。结论:缩窄性心包炎患者心包剥脱术后左心室舒张功能有明显改善,但仍处于舒张功能减退状态。经食道超声心动图可为缩窄性心包炎患者手术后左心室舒张功能监测、后续临床治疗、评估手术治疗效果提供更丰富的信息。
Objectives:To explore the value of transesophageal echocardiography(TEE)in evaluating the changes of left ventricular diastolic function before and after pericardiectomy in patients with constrictive pericarditis.Methods:A total of 30 patients with constrictive pericarditis,who received pericardiectomy under general anesthesia in our hospital from May 2017 to November 2020,were included in this study.Spectrum of mitral orifice flow(E wave and A wave),mitral annulus tissue Doppler(e'wave and a'wave),isovolumetric diastolic time(IVRT),E/A and E/e'ratios were measured at the mid esophagus four-chamber view and mid esophagus long axis view before and after pericardiectomy,respectively.Results:Compared to baseline,E([0.59±0.81]cm/s vs.[0.77±0.09]cm/s),E/A ratios(2.01±0.46 vs.2.76±0.77),E/e'ratios(7.65±1.32 vs.9.16±1.43)and IVRT([95.21±2.75]ms vs.[100.44±2.12]ms)were significantly decreased after pericardiectomy(all P<0.01).A wave remained unchanged after pericardiectomy(P>0.05).Conclusions:The left ventricular diastolic function was improved after pericardiectomy in patients with constrictive pericarditis.TEE can provide accessible information for monitoring left ventricular diastolic function during pericardiectomy.Future studies are needed to explore the association between left ventricular diastolic function changes post pericardiectomy and outcome in these patients.
作者
陈宣伶
秦学伟
赵欣
董超
姚兰
CHEN Xuanling;QIN Xuewei;ZHAO Xin;DONG Chao;YAO Lan(Department of Anesthesiology,Peking University International Hospital,Beijing(102206),China)
出处
《中国循环杂志》
CSCD
北大核心
2023年第1期87-90,共4页
Chinese Circulation Journal
关键词
缩窄性心包炎
心包切除术
经食道超声心动图
左心室舒张功能
constrictive pericarditis
pericardiectomy
transesophageal echocardiography
left ventricular diastolic function
