53例二尖瓣关闭不全的外科修复  

Fifty-three cases of valve repair for mitral insufficiency

作　　者：陈日[1] 陈胜喜[1] 罗万俊[1] 袁明道[1] 蒋海河[1] 林国强[1] 

机构地区：[1]中南大学湘雅医院心胸外科,长沙410008

出　　处：《中南大学学报（医学版）》2008年第2期156-159,共4页Journal of Central South University ：Medical Science

摘　　要：目的:总结二尖瓣关闭不全行二尖瓣成形术的手术治疗方法及治疗效果。方法:对53例二尖瓣关闭不全患者进行二尖瓣成形术,其中男31例,女22例,年龄(23.8±10.4)岁,体质量(43±12)kg,包括二尖瓣脱垂29例,先天性二尖瓣关闭不全17例,风湿性二尖瓣关闭不全5例,原因不明2例。病人均在全麻低温体外循环下行二尖瓣成形术。手术前、后应用彩色多普勒超声心动图观察二尖瓣返流的情况。结果:围术期死亡2例,改行二尖瓣替换1例。其余50例患者术毕二尖瓣无返流或轻度返流。在平均为(13.8±2.5)个月的随访中,二尖瓣返流未见加剧,心功能恢复好。结论:二尖瓣成形术是治疗二尖瓣关闭不全的优选方法,通过严格掌握手术适应证,运用合理的瓣膜成形技术,可获得满意的疗效。Objective To summarize the experience of mitral vavuloplasty for mitral insufficiency in 53 patients. Methods Between January 2001 and September 2006,53 patients （31 males and 22 females ） with mitral insufficiency underwent mitral valve repair at our hospital. The mean age was （ 23.8± 10.4 ） years, and the mean weight was （43 ± 12 ） kg, including 29 cases of mitral prolapse, 17 congenital mitral insufficiency, 5 rheumatic mitral insufficiency, and 2 other etiology. All operations were performed under cardiopulmonary bypass, moderate hypothermia and under the surveillance of transesophagus echocardiography. Results There were 2 early postoperative deaths, and another patient failed to repair and received valve replacement afterward. Postoperative echocardiography indicated that mitral insufficiency was completely corrected in 42 patients, and residual mitral regurginitation in the other 8 patients. During the follow-up with mean period 13. 8 months, 41 patients revealed 28 in NYHA class Ⅰ , 13 in Class Ⅱ. Conclusion Mitral valve repair should be the preferred modes of surgical correction for regurgitate mitral valves. With proper vavuloplasty technique, patients with selective mitral insufficiency patients may achieve satisfactory effect.

关 键 词：二尖瓣成型术 二尖瓣关闭不全 二尖瓣返流 

分 类 号：R654.2[医药卫生—外科学]