Pathologies ntawm cov hlab plawv system yog ib qho ntawm feem ntau ua rau tuag nyob rau hauv cov pejxeem. Cov kab mob no tshwj xeeb tshaj yog cov neeg laus. Kev kuaj mob plawv pathologies thaum ntxov pab txo qis kev pheej hmoo ntawm cov teeb meem thiab kev tuag. Ib txoj hauv kev tshawb fawb yog echocardiography. Txoj kev kuaj mob no yog tsim nyog los ntsuas kev ua haujlwm ntawm lub plawv. Feem ntau, echocardiography yog ua los ntawm kev sojntsuam ultrasound, uas tau muab tso rau ntawm phab ntsa hauv siab. Qee zaum, qhov kev tshawb fawb no tau ua thaum phais. Tom qab ntawd transesophageal echocardiography yog ua. Txoj kev no tso cai rau koj pom lub plawv kom meej ntxiv.
Transesophageal echocardiography - yog dab tsi?
Echocardiography yog ib txoj hauv kev tseem ceeb los kuaj xyuas cov kab mob ntawm cov hlab plawv. Nws tuaj yeem ua tau rau txhua lub hnub nyoog, vim nws tsis yog nrog cov hluav taws xob raug rau lub cev. Ua tsaug rau qhov cuab yeej noTxoj kev tshawb no tuaj yeem pom qhov loj thiab tuab ntawm chav tsev ntawm lub plawv, ntsuas qhov xwm txheej ntawm cov li qub. Transesophageal echocardiography (TEE) txawv nyob rau hauv uas nws yog nqa tawm raws li yog los ntawm sab hauv, thiab tsis yog los ntawm sab nraud (lub hauv siab phab ntsa). Qhov no txhim kho qhov zoo ntawm kev pom. Qhov kev ntsuam xyuas no tsis raug sau tseg rau txhua tus, tab sis tsuas yog rau cov cim tshwj xeeb. Txhawm rau ua echocardiography los ntawm esophageal kab noj hniav, nws yuav tsum xub ua transthoracically. Txoj kev kuaj mob no yog ua los ntawm tus kws kho mob tshwj xeeb hauv tsev kho mob.
Dab tsi yog transesophageal echocardiography raws li?
Transesophageal echocardiography ntawm lub plawv yog ib qho kev kuaj pom raws li ultrasound. Ultrasound yog ua los ntawm kev sojntsuam tshwj xeeb thiab gel. Cov cuab yeej tsim cov suab nrov nrov. Cov ntaub so ntswg "teb" rau cov teeb liab no los ntawm hom echolocation. Muab hais tias txhua lub hauv nruab nrog cev muaj qee qhov ceev thiab cov qauv, lawv tau nthuav tawm txawv ntawm lub vijtsam saib txuas nrog lub cuab yeej. Txoj kev tshawb no yog nqa tawm hauv lub sijhawm. Qhov no txhais tau hais tias tus kws kho mob ntawm kev kuaj mob tuaj yeem ntsuas lub xeev ntawm cov chav hauv lub plawv, thaum lub sensor swb dhau ntawm lub cev. Tsis zoo li transthoracic echocardiography, kev kuaj mob transesophageal tso cai rau koj pom txawm tias qhov txawv txav me me. Qhov tseeb yog tias thaum ua ultrasound ntawm lub hauv siab phab ntsa, nws tsis yog ib txwm ua tau kom ua tiav txaus pom ntawm lub plawv. Qhov no yog vim lub fact tias cov cuab yeej "captures"echo signals los ntawm lwm yam kabmob: tav, nqaij adipose, nqaij nqaij. Thaum ua TEE, "ultrasound window" txo qis, ua rau txoj kev no paub ntau ntxiv.
Kev ntsuas ntsuas
Qhov taw qhia tseem ceeb rau txoj kev tshawb no yog qhov tsis muaj peev xwm ua qhov kev kuaj mob raws li cov ntaub ntawv ntawm transthoracic echocardiography. Feem ntau, txoj kev kuaj mob no yog ua rau cov neeg mob uas xav tias muaj mob plawv loj. Nws tseem yog ib qho tsim nyog nyob rau hauv txoj kev kawm ntawm kab noj hniav ntawm lub cev. Muab hais tias kev kuaj ultrasound los ntawm qhov chaw ntawm lub hauv siab phab ntsa nyob rau hauv cov ntaub ntawv no tsis yog qhia, transesophageal echocardiography yog ua. Test indications:
- Teeb meem tom qab lub plawv li qub. Qee qhov xwm txheej, kev cog ntoo siv sijhawm ntev los txiav cov hauv paus, ua rau mob, abscesses.
- Kev txiav tawm ntawm lub plawv aneurysm lossis aorta.
- Kev ua haujlwm tsis zoo ntawm cov pob qij txha.
- kis kab mob ntawm cov leeg nqaij - endo-, myo-, pericarditis.
- Aortic abscess.
- Yuav tsum tau tshawb fawb thaum lub sijhawm phais.
Ntxiv rau cov lus qhia no, transesophageal echocardiography yog qhov yuav tsum tau ua ua ntej hloov lub valve. Tsis tas li ntawd, txoj kev tshawb no tau ua nrog nce airiness ntawm lub ntsws (emphysema), rog rog.
Contraindications rau transesophageal echocardiography
Txawm hais tias qhov zoo ntawm TEE, txoj kev kuaj no tsis tau siv dav. Qhov no yog vim nws invasive thiab tsis yog txhua tus neeg mob pom zoo rau cov txheej txheem. Tsis tas li ntawd, muaj ntau yam contraindications rau transesophageal echocardiography. Ntawm lawv:
- kab mob kis ntawm qhov ncauj kab noj hniav thiab pharynx.
- Kev tsis txaus ntseeg hauv kev loj hlob ntawm cov kabmob (short esophagus, diverticulum).
- Cicatricial hloov, nruj. Feem ntau pom tom qab lom nrog cov kua qaub lossis alkalis.
- Erosive esophagitis.
- Kab ntshav tawm ntawm lub plab hauv lub plab.
- Nyob rau hauv cov hlab ntsha ntawm cov hlab ntsha hauv daim siab cirrhosis.
- kab mob oncological ntawm qhov ncauj kab noj hniav thiab pharynx.
- mob qog noj ntshav lossis mob plab.
Thaum tsis muaj kab mob hauv plab, TEE tuaj yeem ua rau cov neeg mob ntawm txhua lub hnub nyoog. Tsis tas li ntawd, txoj kev tshawb no tsis yog contraindicated rau cov poj niam cev xeeb tub thiab cov neeg txom nyem los ntawm somatic pathologies. Nws tsis yog nrog irradiation ntawm lub cev.
Kev Npaj rau kev hloov pauv echocardiography
Ua ntej yuav xaj ib qho transesophageal echocardiography, tus neeg mob yuav tsum raug xa mus rau qhov kev kuaj sim. Ntawm lawv: kuaj ntshav biochemical, KLA thiab OAM, coagulogram. Hauv qhov no, kev hloov pauv xws li nce hauv leukocytes, platelets, thiab kev nrawm ntawm ESR tuaj yeem pom. Ntxiv rau, ua ntej noKev kuaj mob, transthoracic ultrasound feem ntau ua. Tsis tas li ntawd, yog xav tias lub plawv pathology yog qhov tsim nyog, ECG yog qhov tsim nyog.
Transesophageal echocardiography yog ib txoj kev nyab xeeb thiab tsis tas yuav npaj tshwj xeeb. Yog tias tus neeg mob noj cov tshuaj, ces nws tsis tas yuav tsum tau muab tshem tawm ua ntej kev kawm. Ib qho yuav tsum tau ua ua ntej rau cov txheej txheem yog qhov tsis kam noj hauv 6 teev ua ntej TEE. Yog tias tus neeg mob muaj cov hniav cuav, lawv yuav tsum tau muab tshem tawm. Qee zaum, premedication yog nqa tawm ua ntej kev kawm. Txhawm rau txo qis salivation, cov tshuaj "Atropine" yog muab tso rau hauv cov hlab ntsha. Yog hais tias tus neeg mob nyob rau hauv lub xeev siab, tranquilizers raug muab tshuaj (cov tshuaj "Diazepam").
Technique rau kev ua transesophageal echocardiography
Kom tsis txhob tsis xis nyob, qhov ncauj thiab caj pas yog tshuaj loog. Rau lub hom phiaj no, cov tshuaj "Lidocaine" los yog "Dikain" yog siv. Tus neeg mob muab tso rau ntawm sab laug. Txhawm rau kom tsis txhob ua kom puas qhov kev sojntsuam thiab pab txhawb nws cov kev taw qhia rau hauv lub pharynx, siv lub qhov ncauj tshwj xeeb. Qhov kawg ntawm lub cuab yeej yuav tsum tau kho nrog ib tug tshwj xeeb gel uas yog siv nyob rau hauv kev kuaj ultrasound. Tom qab ntawd, kev sojntsuam nrog lub endoscope yog muab tso rau hauv kab noj hniav ntawm txoj hlab pas. Txhawm rau txhim kho cov txheej txheem, tus neeg mob yuav tsum ua kom nqos txav. Tsis pub dhau 5-10 feeb, lub cuab yeej yog nyob rau hauv kab noj hniav ntawm txoj hlab pas. Lub teeb endoscope yog coj mus rau lub plawv. Los ntawm cov phab ntsa ntawm txoj hlab pas, lub cuab yeej ntes ncha teeb liab. Lawv tshwm nyob rau hauv lub sij hawmsaib thiab kaw rau ntawm daim kab xev.
Dab tsi tuaj yeem kuaj pom los ntawm transesophageal echocardiography
Ua tsaug rau echocardiography ua los ntawm cov kab noj hniav ntawm txoj hlab pas, nws tuaj yeem ntsuas qhov mob ntawm lub plawv cov leeg, endocardium thiab valvular apparatus. Txoj kev tshawb no yog kev txiav txim siab hauv kev kuaj mob. Muab cov ntaub ntawv siab ntawm cov txheej txheem, txawm tias me me kev puas tsuaj rau lub plawv kab noj hniav tuaj yeem kuaj pom. TEE tso cai rau kuaj pom cov ntshav txhaws, inflammatory kev hloov pauv, aortic dissection. Ib qho kev kawm peb-dimensional yog cov ntaub ntawv tshwj xeeb. Ua tsaug rau 3D ultrasound cardiography, nws muaj peev xwm tsis tsuas yog ntsuas lub xeev ntawm lub plawv cov leeg, tab sis kuj npaj tus neeg mob rau kev phais hloov lub valve. Txoj kev no belongs rau high-tech kev tshawb fawb thiab yog nqa tawm nyob rau hauv cov chaw kho mob tshwj xeeb.
Cov teeb meem tshwm sim ntawm transesophageal echocardiography
Ib txoj kev kuaj mob yog transesophageal echocardiography ntawm lub plawv. Qhov txheej txheem no ua tiav qhov twg? Txoj kev tshawb no yog ua nyob rau hauv dispensaries nrog lub chaw kho mob plawv, nrog rau hauv cov chaw kho mob ntiag tug uas muaj cov cuab yeej kho mob niaj hnub no. Nws yog ib qho tsim nyog yuav tsum nco ntsoov tias, txawm tias muaj kev nyab xeeb, qee zaum muaj teeb meem tshwm sim. Cov no suav nrog kev cuam tshuam lub plawv dhia, nrog rau kev tsis haum tshuaj rau cov tshuaj (tshuaj loog, tranquilizers). Txhawm rau kom tsis txhob muaj qhov tshwm sim loj, nws yog qhov yuav tsum tau npaj cov khoom siv resuscitation.
Transesophageal echocardiography ntawm lub plawv: tawm tswv yim los ntawm cov neeg mob thiab kws kho mob
Txoj kev tshawb no muaj kev nyab xeeb thiab tsis mob, yog li cov neeg mob zam tau zoo. Txhawm rau kuaj xyuas cov kab mob loj, transesophageal echocardiography yog ua. Kev tshuaj xyuas cov kws kho mob txog txoj kev kuaj no yog qhov zoo. Cov kws kho mob sau nws cov ntsiab lus siab thiab kev nyab xeeb.
