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目的探讨TEE检测非瓣膜性房颤左心耳的大小及功能与左心耳内血栓形成之间的关系,为临床进行风险评估、判断愈后及指导治疗等方面提供重要依据。方法采用TEE对41例非瓣膜性房颤伴有或不伴有高血压患者进行左心耳检测,根据左心耳的形态特点,测量出左心耳入口的宽度、左心耳顶部到入口的长度,同样用描记法测出左心耳舒张末容积,运用脉冲多普勒测出左心耳血流充盈与排空速度,检测左心耳内透声情况及有无血栓。结果41例房颤患者中左心耳血栓7例,有血栓组与无血栓组的左心耳的大小、容积无显著性差异,而左心耳的峰值血流排空速度差异具有显著性;随房颤病程变化,左心耳容积具有显著性差异(P<0.05);房颤伴高血压组与不伴高血压组上述指标亦具有显著性差异。结论左心耳大小、形态的改变,功能的减低,血流速度的减慢是房颤患者左心耳内血栓形成的重要危险因素。因此,对左心耳大小、形态及功能的检测可以帮助临床进行风险评估、判断愈后以及指导治疗等方面都有着重要的临床价值。
Objective To explore the relationship between the size and function of TEE in detecting atrial appendage of atrial fibrillation and thrombus formation in left atrial appendage and to provide an important basis for clinical risk assessment, prognosis and guidance treatment. Methods TEE was used to detect left atrial appendage in 41 patients with or without atrial fibrillation. According to the morphology of the left atrial appendage, the width of the left atrial appendage and the length of the left atrium were measured. Tracing method to measure the left atrial appendage diastolic volume, the use of pulsed Doppler measured left atrial appendage flow filling and emptying rate, detection of left atrial appendage sound and thrombosis. Results In 41 patients with atrial fibrillation, there were 7 cases of left atrial appendage thrombus, there was no significant difference in the size and volume of left atrial appendage between thrombosis group and non-thrombus group, while the peak velocity of left atrial appendage was significantly different. Duration of change, left atrial appendage volume was significantly different (P <0.05); atrial fibrillation with and without hypertension group also had significant differences in the above indicators. Conclusion Left atrial appendage size, morphological changes, reduced function and slowed blood flow velocity are the important risk factors of thrombus in the left atrial appendage. Therefore, the detection of left atrial appendage size, shape and function can help clinical risk assessment, prognosis and guidance treatment has important clinical value.