Iwasaki Tatsuo, Takeuchi Mamoru, Oe Katsunori, Taga Naoyuki, Morita Kiyoshi
Department of Anesthesiology and Resuscitology, Okayama University Medical School, Okayama 700-8558.
Masui. 2004 Mar;53(3):264-8.
This report describes usefulness of intraoperative transesophageal echocardiograpy (TEE) based on 773 cases we experienced in 7 years. We assessed residual lesions, ventricular function and preload with TEE. We found a case with stenotic lesion in her lateral tunnel which TEE revealed after Fontan procedure. We also ensured that no micro air bubble was in the left ventricle and the left atrium before weaning from cardiopulmonary bypass. No patient suffered from convulsion during postoperative management after induction of intraoperative TEE examination though we had had some cases in the previous year. Respiratory compromise was observed in 3 cases (0.5%) and significant hemodynamic change occurred in 9 cases (1.3%). The conditions improved just after withdrawing TEE probe. Neither inadvertent tracheal extubation, nor serious complication occurred during TEE examinations. The incidence of complications during pediatric TEE is low and TEE examination is useful for pediatric patients with congenital heart disease.
本报告基于我们7年间经手的773例病例,描述了术中经食管超声心动图(TEE)的效用。我们通过TEE评估残余病变、心室功能和前负荷。我们发现1例患者在Fontan手术后,TEE显示其侧隧道存在狭窄病变。我们还确保在体外循环撤机前左心室和左心房内没有微气泡。尽管上一年我们有过一些病例,但在术中TEE检查后诱导的术后管理期间,没有患者发生惊厥。观察到3例(0.5%)出现呼吸功能不全,9例(1.3%)发生显著血流动力学变化。拔出TEE探头后情况立即改善。在TEE检查期间,既没有发生意外气管拔管,也没有出现严重并发症。小儿TEE检查期间并发症的发生率较低,且TEE检查对患有先天性心脏病的小儿患者有用。