保留瓣下结构对二尖瓣置换术后左心功能的影响  

Influence on left heart function after mitral valve replacement with preservation of subvalvular apparatus

作　　者：马千里[1] 唐闽[1] 于丁[1] 王宪德[1] 

机构地区：[1]河北医科大学第二医院心外科,石家庄050000

出　　处：《医师进修杂志（外科版）》2005年第4期16-18,共3页

摘　　要：目的　探讨保留瓣下结构对二尖瓣置换术后左心功能的影响。方法　将85例行单纯二尖瓣替换的风湿性心脏病患者,根据术中对二尖瓣不同处理方式分为三组:1组(32例)全部切除瓣下结构;2组(43例)保留后瓣组;3组(10例)保留全部瓣下结构。对患者进行随访,并采用二维超声心动图、彩色多普勒技术测量患者左心功能,比较各组间差别。结果　1组与2组、3组间各种参数差别均具有显著差异(P <0 .0 5 ) ,2组与3组间左心室舒张末径(LVEDD)、左心室收缩末径(LVESD)、左心室射血分数(EF)、左心室短轴缩短率(FS)有显著差异(P <0 .0 5 )。结论　二尖瓣替换术中,保留瓣下结构对患者术后左心功能改善的影响优于不保留瓣下结构,全部保留瓣下结构优于部分保留瓣下结构。Objective To study the effects of left heart function after mitral valve replacement with preservation of subvalvular apparatus (MVRP). Methods 85 patients of rheumatic heart disease were operated with mitral valve replacement (MVR). All patients were divided into three groups according to the different management of native valve during operation: 32 cases of valve un-preservation group (group Ⅰ), 43 cases of preservation of posterior valve group (groupⅡ) and 10 cases of preservation of global valve group (group Ⅲ). All patients were followed up with examination of two dimensional echocardiography and color Doppler. The parameters of left heart function were measured. Difference among the three groups were compared. Results There were significant difference in these parameters among the groups (P<0.05). There was a significant difference between group Ⅱ and Ⅲ in LVEDD, LVESD, EF and FS (P<0.05). Conclusions The postoperative influence on left heart function in MVRP group is better than normal MVR group. Total preservation of subvalvular apparatus is better than partial preservation of subvalvular apparatus.

关 键 词：二尖瓣置换术 左心功能 保留瓣下结构 风湿性心脏病 

分 类 号：R654.2[医药卫生—外科学]