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经鼻食管超声心动图在超声诊断中的可行性研究

The feasibility study of transnasopharyngeal esophagus echocardiography in the ultrasonic diagnosis.

作者信息

Wang Xiaofeng, Nie Fang, Ye Na, Liu Xuehui, Yang Shaoqing

机构信息

Lanzhou University Second Hospital, Linxia Road, Chengguan District, Lanzhou City, 730030, Gansu Province, China.

出版信息

Cardiovasc Ultrasound. 2019 Mar 1;17(1):4. doi: 10.1186/s12947-019-0154-2.

Abstract

BACKGROUND

Professor Xinfang Wang first introduced the clinical application of trans nose pharynx esophagus echocardiography (TNPEE) in 2014. Subsequently, we developed the technology. In the present study we assess the feasibility of TNPEE in the ultrasonic diagnosis.

METHODS

Select patients suitable for TNPEE examination. After obtaining written consent of patients or their families, oral dacronin hydrochloride gel local anesthesia was given 10-15 min before examination. The nostrils were disinfected and then smeared with tetracaine hydrochloride gel, which acted as local anesthesia and lubrication. The probe was inserted gently through the nostrils and entered the esophagus through the nasal cavity and pharynx. TNPEE is similar to transoral esophagus echocardiography (TOEE) after the probe reaches the esophagus.

RESULTS

TNPEE was performed in 103 patients. Forty-five patients (43.7%) underwent the examination successfully, 46 patients (44.7%) failed because of objective reasons, 12 patients midway refused to accept the examination and cancelled the examination, accounting for 11.6%, 11 patients (12.1%) suffered from epistaxis. Of all the patients with epistaxis, 9 had taken anticoagulant drugs, accounting for 82% of the patients with epistaxis. The vital signs of all patients were stable and no serious complications occurred.

CONCLUSION

Compared with TOEE, TNPEE can cause less nausea and vomiting reaction, and patients take longer time to undergo examination, which is conducive to more detailed examination. However, TNPEE has a high requirement for the probe, and its success rate is relatively low. It is easy to cause nasal bleeding in patients, so its wide clinical application is limited.

摘要

背景

王新房教授于2014年首次介绍了经鼻咽喉食管超声心动图(TNPEE)的临床应用。随后,我们对该技术进行了改进。在本研究中,我们评估了TNPEE在超声诊断中的可行性。

方法

选择适合TNPEE检查的患者。在获得患者或其家属的书面同意后,于检查前10 - 15分钟给予口服达克罗宁盐酸盐凝胶局部麻醉。对鼻孔进行消毒,然后涂抹盐酸丁卡因凝胶,起到局部麻醉和润滑作用。将探头轻轻经鼻孔插入,经鼻腔和咽喉进入食管。探头到达食管后,TNPEE与经口食管超声心动图(TOEE)类似。

结果

103例患者接受了TNPEE检查。45例患者(43.7%)检查成功,46例患者(44.7%)因客观原因检查失败,12例患者中途拒绝接受检查并取消检查,占11.6%,11例患者(12.1%)发生鼻出血。在所有鼻出血患者中,9例服用过抗凝药物,占鼻出血患者的82%。所有患者生命体征平稳,未发生严重并发症。

结论

与TOEE相比,TNPEE引起的恶心呕吐反应较少,患者接受检查的时间较长,有利于更详细的检查。然而,TNPEE对探头要求较高,成功率相对较低,容易导致患者鼻出血,因此其临床广泛应用受到限制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/55f6/6397502/59a441df0231/12947_2019_154_Fig1_HTML.jpg

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