Orihashi K, Hong Y, Sisto D A, Goldiner P L, Oka Y
Department of Anesthesiology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY 10461.
J Cardiothorac Anesth. 1990 Dec;4(6):726-30. doi: 10.1016/s0888-6296(09)90011-4.
This study was performed to clarify the location of a transesophageal echocardiographic (TEE) transducer when obtaining the short-axis view of the left ventricle (S-LV). The depth of the probe tip from the incisors when obtaining a S-LV, the relationship to the diaphragm, and the location of the cardia of the stomach using a gastroscope attached to the TEE probe were measured in 24 patients undergoing coronary artery bypass grafting. The location of the transducer relative to the cardia and diaphragm was determined. The study demonstrated that when obtaining a S-LV, the transducer was in the stomach in 72.7%, at the cardia in 13.6%, and in the esophagus in 13.6% of the patients. The predominantly intragastric position of the transducer suggests that gastric diseases should be included as contraindications to TEE. When the probe was advanced about 40 cm from the incisors, some resistance was often encountered by the TEE operator at about the level of the diaphragm. Careful manipulation is mandatory to avoid tissue damage by the probe. Visualization of the S-LV can be disturbed by gas in the stomach. This is a specific problem in anesthetized patients because gas is often pushed into the stomach at the time of induction.
本研究旨在明确经食管超声心动图（TEE）探头在获取左心室短轴视图（S-LV）时的位置。在24例接受冠状动脉旁路移植术的患者中，测量了获取S-LV时探头尖端距门齿的深度、与膈肌的关系以及使用连接在TEE探头上的胃镜观察胃贲门的位置。确定了探头相对于贲门和膈肌的位置。研究表明，获取S-LV时，72.7%的患者探头位于胃内，13.6%位于贲门处，13.6%位于食管内。探头主要位于胃内的情况提示，胃部疾病应被列为TEE的禁忌证。当探头从门齿推进约40 cm时，TEE操作者在膈肌水平处常遇到一些阻力。必须小心操作以避免探头造成组织损伤。胃内气体可干扰S-LV的可视化。这在麻醉患者中是一个特殊问题，因为诱导时气体常被压入胃内。
