二尖瓣成形术的临床应用  

Clinical application of the mitral valvuloplasty

作　　者：刘志芳[1] 陈艰[1] 王荣胜[1] 陈立军[1] 张平[1] 胡建明[1] 谢爱民[1] 

机构地区：[1]江西省人民医院心胸外科,南昌330006

出　　处：《江西医药》2008年第10期1008-1010,共3页Jiangxi Medical Journal

摘　　要：目的总结34例行二尖瓣修复成形术的二尖瓣关闭不全患者的临床疗效。方法从2006年1月～2007年12月,对34例二尖瓣关闭不全患者行修复成形术,男14例,女20例,平均年龄(36.9±16.6)岁。手术在体外循环、中低温下施行,采用瓣叶切除缝合、瓣环成形、腱索转移、"双孔"技术,术中以食道超声监测成形效果。结果全组无手术死亡。术后经食管超声心动图(TEE)检查二尖瓣反流消失28例,微量反流或少量反流6例。术后左心房、左心室缩小,与术前比较差别有显著性意义(P<0.001)。术后6个月心功能均有明显提高。结论对于二尖瓣关闭不全的患者,术中准确判断二尖瓣的病变,采用相应的成形技术,可以取得满意的治疗效果。Objective To summarize and analyze the clinical effect of 34 mitral insufficiency treated with mitral valvuloplasty.Methods From january 2006 to december 2007,34 consecutive patients,with mitral insufficiency undertook mitral valvuloplasty at our center. All operations were performed under extracorporeal circulation,moderate hypothermia and under the surveillance of transesophagus echocardiography.Valvuloplasty technique included sliding technique, annuloplasty,chordal transfer,edge to edge technique. Results There was no perioperative death in the 34 patients, and no one received valve replacement afterwards.Echocardiography demonstrated absence of mitral regurgitation in 28 patients,trivial regurgitation or mild regurgitation in 6.All patients had a reduction of left atrial diameter （from 46.18±15.8mm to 34.71±9.9mm,P〈0.001）and left ventricular end diastolic diameter （from 62.1±11.5 mm to 52.8± 9.7mm,P〈0.001）after operation.New York Heart Association （ NYHA）functional class of the patients improved significantly in 6 months after operation.Conclusion With proper valvuloplasty technique,selective mitral insufficient patients should achieve satisfying effect.

关 键 词：二尖瓣成形术 二尖瓣关闭不全 二尖瓣返流 

分 类 号：R542.51[医药卫生—心血管疾病]