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目的评价经食管超声心动图(TEE)对指导小儿先天性心脏病(先心病)外科手术和介入治疗的应用价值及其安全性。方法2000年11月至2005年1月,在上海市复旦大学附属儿科医院心血管中心接受外科开胸手术或经导管介入治疗的先心病患儿中有317例进行了TEE检查,年龄2个月至17岁6个月(平均4.7岁)。采用HP/SONOS2500超声诊断仪,频率5.5～7.5MHz双平面经食管探头,全麻状态下进行。结果与术前经胸超声心动图(TTE)比较,术前TEE检查对诊断作出修正或补充者51例(16.1%),其中因此而修正了手术治疗方案25例(7.9%)。术后TEE检查发现有并发症或残余问题57例(18.0%),其中8例(2.5%)因此立即再次手术。所有病例均未因TEE检查而引起并发症。结论TEE可安全地应用于小儿先心病围术期检查,对术前诊断做出修正或补充,术后可及时发现并发症或残余问题。
Objective To evaluate the value and safety of transesophageal echocardiography (TEE) in guiding the surgical and interventional treatment of children with congenital heart disease (CHD). Methods From November 2000 to January 2005, 317 patients with congenital heart disease undergoing thoracotomy or catheterization at the Cardiovascular Center of Pediatric Hospital, Fudan University, Shanghai City, were examined by TEE, age 2 months To 17 years and 6 months (average 4.7 years old). Using HP / SONOS2500 ultrasonic diagnostic apparatus, the frequency of 5.5 ~ 7.5MHz dual plane transesophageal probe, carried out under general anesthesia. Results Compared with preoperative transthoracic echocardiography (TTE), 51 cases (16.1%) were diagnosed or supplemented by preoperative TEE examination. Among them, 25 cases (7.9%) were corrected by surgery. Fifty-seven (18.0%) patients had complications or residual problems after TEE examination, and eight (2.5%) of them were reoperated immediately. All cases did not cause complications due to TEE examination. Conclusion TEE can be safely applied in perioperative examination of congenital heart disease in children, and the preoperative diagnosis can be corrected or supplemented. The complications or residual problems can be found in time.