合并心功能受损非缺血性二尖瓣反流的外科修复  

Surgical Repair for Non-ischemic Mitral Regurgitation with Left Ventricular Dysfunction

作　　者：朱丹[1] 王哲[1] 陈安清[1] 夏利民[1] 王春生[1] 赵强[1] 

机构地区：[1]复旦大学附属中山医院,上海市心血管病研究所,上海200032

出　　处：《中国临床医学》2009年第5期692-694,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:评价合并心功能受损非缺血性二尖瓣反流的外科修复的近中期疗效。方法:选取19例合并心功能受损非缺血性二尖瓣反流的患者行二尖瓣成形术[入选标准为射血分数(EF)<50%,排除合并冠心病和感染性心内膜炎者],其中男性10例,女性9例。年龄33～72岁,平均(53.4±9.3)岁。比较其术前、术后的心功能,左心室、左心房直径和二尖瓣反流程度的变化。结果:随访时间2个月～59个月,平均(28.8±15.2)个月。1例死于术后16个月。存活患者的左心室收缩功能较术前明显改善,EF值从术前0.41±0.05增至0.47±0.09,P<0.05。左心室及心房亦较术前缩小,左房直径从术前49.14±7.24mm减少至38.43±4.86mm,P<0.05;左室舒张末直径从术前65.29±8.58mm减少至59.57±8.08mm,P<0.05,左室收缩末直径从术前51.0±6.60mm减少至47.36±4.23mm,P<0.05。术后二尖瓣反流程度明显减轻,从术前3.55±0.37降至术中食管超声1.26±0.81,中期二尖瓣反流程度为1.67±0.96(P<0.05)。Objective：To evaluate the clinical application and midterm result of surgical repair for non-ischemic mitral regurgitation with left ventricular dysfunction. Methods： Nineteen patients with left ventricular dysfunction comprised the study group （excluding the cases with coronary artery disease or infective endocarditis）. The data of the cardiac function, the diameter of left ventricular and left atria and the degree of mitral regurgitation were analyzed before and after operation. Results： The degree of mitral regurgitation decreased after operation significantly. The mean degree of pre-operation mitral regurgitation was 3.55± 0.37, and the follow-up degree was 1.67±0.96 （P〈0.05） ,respectively. The diameter of left ventricular and left atria reduced. The postoperative cardiac function improved apparently. EF increased from 0.41± 0.05 preoperatively to 0.47 ±0.09 postoperatively,P〈0.05. Conclusion：Surgical repair is a safe and effective technique for non-ischemic mitral regurgitation with left ventrieular dysfunction.

关 键 词：二尖瓣反流 左室功能受损 二尖瓣成形术 

分 类 号：R654.2[医药卫生—外科学]