经皮二尖瓣球囊成形术治疗风湿性心脏病二尖瓣狭窄47例临床观察  

Study on 47 cases of mitral stenosis with severe calcification treated with percutaneous balloon mitral valvuloplasty

作　　者：欧知宏[1] 袁方[1] 石增成[1] 徐同龙[1] 侯子山[1] 

机构地区：[1]山东省临沂市人民医院心内科,276002

出　　处：《中国医师进修杂志（内科版）》2007年第6期28-29,共2页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨风湿性心脏病（RHD）伴重度钙化的二尖瓣狭窄（MS）患者行经皮二尖瓣球囊成形术（PBMV）的安全性及远期疗效。方法对47例RHD伴重度钙化的MS患者采用逐步球囊扩张法行PBMV。结果与术前比较，术后即刻平均左房压、二尖瓣跨瓣压差显著下降（P〈0．01）；术后第3天超声心动图示二尖瓣口面积显著扩大（P〈0．01），心功能明显改善（P〈0．01），左房内径、肺动脉收缩压显著减小（P〈0．05或〈0．01），左室内径无显著变化（P〉0．05）。46例患者平均随访（31±5）个月，左房内径、左室内径、二尖瓣口面积、肺动脉收缩压及心功能与术后第3天比较，差异无统计学意义（P〉0．05）。结论采用逐步球囊扩张法行PBMV治疗RHD伴重度钙化的MS是一种安全、有效的方法．Objective To evaluate the short term and long term effect of mitral stenosis （MS） with severe calcification treated with pereutaneous balloon mitral valvuloplasty（PBMV）. Method Forty - seven cases of MS with severe calcification were treated with PBMV in gradually enlarging method. Results The left atrial pressure（LAP） and mitral valve gradient（MVG） decreased significantly during operation（ P 〈0. 01 ）. Three days after PBMV, mitral valve area（MVA） increased and the heart function improved markedly（P〈0. 01 ）. Left atrial diameter（LAD） and pulmonary artery pressure（PAP） decreased significantly（P 〈0.05 or 〈0. 01 ）. There was no significant change in end diastolic diameter of left ventricle（ P 〉 0. 05 ）. Forty -six cases were followed up for（ 31 ± 5 ） months. There was no significant difference in LAD, LVD, MVA, PAP and heart function comparing with those of 3 days after procedure （ P 〉 0. 05 ）. Conclusion Gradually enlarging method of PBMV is an effective and safe method to treat patients with MS and severe calcification.

关 键 词：二尖瓣狭窄 经皮二尖瓣球囊成形术 钙化 超声心动图 

分 类 号：R654.2[医药卫生—外科学]