二尖瓣综合成形术──临床病理研究与手术策略探讨  

Study of clinical pathology and discussion of surgicalstrategy in comprehensive mitral valvuloplasty

作　　者：刘维永[1] 杨景学[1] 张卫达[1] 晏培松[1] 陈钢[1] 

机构地区：[1]第四军医大学西京医院心胸外科

出　　处：《中华外科杂志》1994年第1期4-7,T001,共5页Chinese Journal of Surgery

摘　　要：作者对１６２例二尖瓣成形术中二尖瓣临床病理观察结果和同期摘除的８个瓣膜病理解剖结果进行了分析，以探讨手术策略。Ｉ型病变６４例，ＩＩ型２３例，ＩＩＩ型７５例，其中２２例为先天性，２７例退行性变，１例为感染性心内膜炎，余１１２例为风湿性病变。摘除的瓣膜中，７例为风湿性，均为ＩＩＩ型病变。瓣膜全部结构均受累，瓣叶明显增厚，瓣口呈漏斗或半漏斗型。镜检：增生胶原纤维与瓣叶组织无明显界面，有的腱索并包埋于增厚瓣膜组织中，胶原纤维呈透明性变，有的并见到钙化、灶性坏死区和炎细胞浸润。AbstractThe results of clinical pathologic study of 162 mi-tral valves(MV)intraoperatively and pathologicanatomy of 8 excised MV were reported. Type I 64cases,type II 23 cases and type III 75 cases. Thepathogenic causes were congenital heart disease in 22cases degeneration in 27 cases infective endocarditis in1 case and rheumatic disease in 112 cases. Of the ex-cised MV, 7 rheumatic lesion with type III. All valvecomponents were involved. The valve leaflets thick-ened significantly and valve orifice changed like a fun-nel or semi-funnel shape. Under light microscope therewas no interface between the increased collagen fibersand the valve tissue. Some superficial collagen fibersappeared hyalinosis. The calcification, local necrosisand inflammatory cell infiltration could seen in somecases but the rhenmatic body and the chordaetendineae wraped up in the thickened valve tissue onlyin one case respectively degenerative lesion with thinchordae tendineae whicn appeared muco-hyalinosis andruptured in three points.According to the clinical pathology of MV the in-dication and surgical technigue are discussed

关 键 词：二尖瓣 成形术 临床 病理 

分 类 号：R654.2[医药卫生—外科学]