特发性二尖瓣腱索断裂手术治疗的临床分析  

Study on characteristics and regularity of idiopathic mitral chordal rupture after surgery therapy from 188 hospitalized patients

作　　者：罗晓亮[1] 吕锋 袁建松[1] 吕秀章 刘蓉 张峻 杨跃进[1] 乔树宾[1] 

机构地区：[1]中国医学科学院北京协和医学院阜外心血管病医院心血管病研究所心内科,北京市100037 [2]中国医学科学院北京协和医学院阜外心血管病医院心血管病研究所心外科,北京市100037 [3]中国医学科学院北京协和医学院阜外心血管病医院心血管病研究所超声科,北京市100037

出　　处：《中国分子心脏病学杂志》2011年第4期193-195,共3页Molecular Cardiology of China

摘　　要：目的探讨特发性二尖瓣腱索断裂的临床特征、发病规律、治疗方法及术后康复情况。方法对188例经手术治疗的特发性二尖瓣腱索断裂住院患者的临床资料及随访情况进行回顾性分析。结果前叶腱索断裂49例,后叶腱索断裂129例,前后叶腱索断裂10例。腱索部分断裂172例,完全断裂16例。72例患者术前伴有心房颤动,26例术后自动转复为窦性心律,5例患者术前伴有阵发性心房扑动,术后及随访期间均为窦性心律。结论特发性二尖瓣腱索断裂后叶发病率高于前叶,前后叶腱索均断裂较少见,术前左心房内径大小与心房颤动术后能否自动转复密切相关,特发性二尖瓣腱索断裂手术治疗预后良好。Purpose To investigate the clinical feature, therapeutic method, and postoperation rehabilitation of idiopathic rupture of mitral valve chordae tandineae .Method: A total of 188 patients with idiopathic repture of mital valve chordae tandineae was retrospectively recruited and analyzed. Result : Forty-nine patients had anterior lobe of chordae tandineae rupture, 129 had posterior lobe of chordae tandineae rupture, and 10 had both of the lobes rupture . Among them, part of chordae tandineae rupture occured in 172 cases , and completely rupture in 16 cases. Seventy-two patients had atrial fibrillation before surgery, of which 26 patients turned to sinus rhythm automatically after operation. Preoperative 5 cases companion had atrial flutter, but after operation and during the follow-up period they all turned to sinus rhythm. Conclusion: The incidence of posterior leaflet rupture was higher than that of anterior leaflet rupture. Rupture of both anterior and posterior leaflet was rare. The prognosis index of whether the atrial fibrillation could turn to sinus rhythm automatically after surgery was the internal diameter of left atrium. Surgery for the treatment of idiopathic mitral valve chordae tendineae rupture was effective .

关 键 词：腱索断裂 二尖瓣关闭不全 瓣膜置换 瓣膜成形 心房颤动 

分 类 号：R654.2[医药卫生—外科学]