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目的探讨经胸超声心动图在室间隔缺损(VSD)伴室间隔膜部瘤封堵术中的应用价值。方法35例VSD伴膜部瘤患者,术前明确VSD大小,数目,膜部瘤基底部直径、瘤体长度,以及VSD上缘和膜部瘤基底部上缘距主动脉瓣(AV)距离,术中经胸超声心动图(TTE)监护引导,术后追踪随访。封堵器采用Amplatzer膜部室缺封堵器、国产自膨胀性膜部封堵器及PDA蘑菇伞封堵器。结果左室造影与经胸超声心动图测量VSD大小,数目,膜部瘤直径等大致相符(P>0.05),VSD上缘及膜部瘤基底部上缘距主动脉瓣距离2种方法检测有差异(P≤0.05)。35例患者中33例即刻封堵成功,其余2例未封堵成功者与经胸超声心动图检查应用无直接关系。结论经胸超声心动图在VSD并膜部瘤封堵术前病例筛选、术中监护引导、术后随访有着其他检查不可替代的临床应用价值。
Objective To investigate the clinical value of transthoracic echocardiography in the occlusion of ventricular septal defect with ventricular septal defect (VSD). Methods 35 cases of VSD with membranous tumor were enrolled in this study. The size and number of VSD, the diameter of tumor base, the length of tumor and the distance between the upper edge of VSD and the aortic valve (AV) Intraoperative transthoracic echocardiography (TTE) monitoring and guidance, follow-up after surgery. Occluder using Amplatzer Membrane chamber occluder, made from the expansion of the diaphragm occluder and PDA mushroom umbrella occluder. The results of left ventricular angiography and transthoracic echocardiography measurement of VSD size, the number of tumor diameter and other similar (P> 0.05), VSD and mesenteric basal margin of the basal aortic valve margin from the two methods to detect Difference (P≤0.05). Thirty-three of the 35 patients were successfully blocked immediately, and the remaining two patients who did not have a successful occlusion were not directly related to transthoracic echocardiography. Conclusion Transthoracic echocardiography in the VSD and membranous tumor occlusion preoperative screening, intraoperative monitoring guide, postoperative follow-up has irreplaceable clinical value of other tests.