三尖瓣人工软环成形术  

Clinical application of tricuspid flexible ring in secondary tricuspid insufficieney patients

作　　者：刘志芳[1] 陈艰[1] 胡建明[1] 谢爱民[1] 徐全[1] 章晔[1] 王荣胜[1] 

机构地区：[1]江西省人民医院心胸外科, 南昌330006

出　　处：《中华胸心血管外科杂志》2009年第5期292-294,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的探讨三尖瓣人工软环成形术与非人工软环成形术相比是否具有更好的成形效果。方法分析2005年1月至2007年12月收治的55例继发性三尖瓣关闭不全病人的临床资料。其中风湿性心脏病51例，房间隔缺损3例，室间隔缺损1例；三尖瓣成形中29例采用Kay成形术或DeVega成形术，26例行人工软环成形术。两组术前心功能分级、三尖瓣反流程度、肺动脉压力差异无统计学意义。结果两组均无手术死亡，两组病人术后右心房、右心室缩小，与术前比较差别均有统计学意义（P〈0．05），组间差异亦有统计学意义。随访6—40个月，非人工软环组出现三尖瓣重度反流3例；人工软环组未出现三尖瓣严重反流。结论三尖瓣人工软环成形效果优于非人工软环成形术。Objective The purpose of this study was to compare the efficacy of tricuspid valve （TV） repair with or without a flexible ring in patients with secondary tricuspid insufficiency. Methods Clinical date of 55 cases of secondary tricuspid insufficiency from January 2005 to December 2007 was analyzed. The original heart diseases were 51 rheumatic, 3 atrial septal defect and 1 ventricular septal defect. Twenty-nine patients underwent DeVega or Kay annuloplasty, and 26 had a flexible ring annuloplasty. There were no significant preoperative differences regarding NYHA functional class, TR grade, and pulmonary artery pressure between the two groups. Results All patients survived and recovered after the operation. There was a reduction of right atrial diameter and right ventricular end diastolic diameter as compared with the preoperative data. Also there was significant difference between the two groups. Patients were followed up from 6 to 40 months. Three patients severe tricuspid regurgitation were found in nonflexible ring group and none in flexible ring group. Conclusion The efficacy of flexible ring is superior to that of traditional DeVega technique or Kay inethed in patients with secondary tricuspid insufficiency.

关 键 词：三尖瓣闭锁不全 心脏外科手术 人工软环 

分 类 号：R686[医药卫生—骨科学]