巨大左心室瓣膜置换术后左室重构与左心室收缩功能的关系  

Left ventricular remodeling and systolic performance after valve replacement for valvular heart disease with giant left ventricle

作　　者：何进喜[1] 边虹[1] 郭德和[1] 

机构地区：[1]宁夏医学院附属医院,宁夏银川750004

出　　处：《宁夏医学杂志》2008年第10期880-881,共2页Ningxia Medical Journal

摘　　要：目的观察巨大左室患者瓣膜置换术后左心室重构的变化,探讨其与左室收缩功能的关系。方法回顾性分析33例巨大左心室患者瓣膜置换术的临床资料,对比术前、术后不同时期心脏超声心动图(UCG)检查结果和心功能变化。结果术后1个月和3个月左心室舒张期末内径(LVEDD)、左心室收缩期末内径(LVESD)、左室舒张末容积(LVEDV)、左室收缩末容积(LVSDV)、左心室射血分数(LVEF)、左心室短轴缩短率(LVFS),均较术前减小或降低(P<0.05)。结论对于合并巨大左室者,争取尽早手术(LVDS<6.0 cm前),有利于术后左心室形态的逆转和左心收缩功能的恢复。Objective To observe the left ventricular remodeling and evaluate its relationship with left ventricular systolic performance after valve replacement for valvular heart disease with giant left ventricle.Methods 33 patients with valvular heart disease and giant left ventricle after valve replacement was retrospectively reviewed.The results of ultrasonic cardiography（UCG） and the changes of cardiac function before and after operation were compared.Combined mitral and aortic valve replacement was performed in 8 cases,mitral valve replacement in 4 cases,aortic valve replacement and ventricular septal defect neoplasty in 2 cases,aortic valve replacement andcoronary artery bypass graft in 2 cases,Bental＇s operation in 5 cases,tricuspid valve annuloplasty in 7 cases.Results The value of left ventricular end-diastolic dimension（LVEDD）,left ventricular end-systolic dimension（LVESD）,The value of left ventricular end-diastolic volume（LVEDV）,left ventricular end-systolic volume（LVESV）,left ventricular ejection fraction（LVEF）,left ventricular fractional shortening（LVFS） in 1 and 3 months after operation were more decreased than those before operation（P〈0.05）.Conclusion Early operation are in favor of left ventricular geometry reversal and systolic function improvement for patients with GLV.The protection for cardiac function should be carefully taken in order to prevent the occurrence of complication after operation.

关 键 词：心脏瓣膜疾病 巨大左心室 瓣膜置换 左心室重构 

分 类 号：R654.2[医药卫生—外科学]