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经食道二维超声心动图(TEE)的出现,给手术期间连续监测心脏提供了新的手段。用超声心动图观察左室、区域性室壁运动(RWM)异常和收缩期室壁增厚(S WT),是监测心肌缺血的早期和敏感的指标。最近Smith注意到TEE监测室壁运动,判断心肌缺血,较沿用的心电图和肺小动脉楔压的监测,更为敏感和及时。左室区域性功能,用RWM或SWT评价左室整体功能,则从计算面积改变分数(fractional area Change,FAC)或面积射血分数(area ejection fraction)为指标。本文用TEE监测11例行冠状动脉旁路手术病人,术中左室整体和区域性功能的各项指标,并评价测试的重复性。
The presence of transesophageal echocardiography (TEE) provides a new means of continuously monitoring the heart during surgery. Left ventricular and regional wall motion (RWM) abnormalities and systolic wall thickening (S WT) were observed with echocardiography, an early and sensitive indicator of myocardial ischemia. Recently Smith noticed that TEE monitors ventricular wall motion and determines myocardial ischemia, which is more sensitive and timely than the monitoring of ECG and pulmonary arterial wedge pressure. Left ventricular regional function was assessed using RWM or SWT for global left ventricular function, using either fractional area change (FAC) or area ejection fraction as an index. In this paper, TEE 11 cases underwent coronary artery bypass surgery patients with intraoperative left ventricular global and regional function of the indicators, and evaluation of the test repeatability.