1625例经皮球囊二尖瓣成形术回顾性分析  

Retrospective analysis about percutaneous balloon mitral valvuloplasty 1625 cases

作　　者：徐先增[1] 黄凯[1] 曾知恒[1] 伍伟锋[1] 朱立光[1] 李醒三[1] 陶新智[1] 刘唐威[1] 

机构地区：[1]广西医科大学第一附属医院心内科,南宁530021

出　　处：《临床心血管病杂志》2010年第6期450-452,共3页Journal of Clinical Cardiology

基　　金：广西科技攻关项目(桂科攻:0472002-30)

摘　　要：目的:探讨Inoue法经皮球囊二尖瓣成形术(PBMV)的效果和安全性。方法:分析我院自1992年至今资料相对完整的1625例PBMV患者,评价手术前后心导管、超声心动图与临床心功能等各项指标,并统计手术成功率与并发症发生率。结果:技术性成功率98.71%。左房平均压术前(22.76±8.85)mmHg(1mmHg=0.133kPa),术后(14.15±6.11)mmHg(P<0.001);左房内径术前(49.42±9.71)mm,术后(45.16±8.27)mm(P<0.001);二尖瓣瓣口面积术前(1.11±0.29)cm2,术后(2.01±0.65)cm2(P<0.001);跨二尖瓣平均压差术前(12.18±5.85)mmHg,术后(3.21±3.77)mmHg(P<0.001)。手术并发症例数96例(5.90%),二尖瓣反流71例(4.37%),心脏穿孔或心包填塞13例(0.80%),系统性栓塞9例(0.55%),其他5例(0.31%)。导致死亡2例(0.12%),需要急诊外科干预11例(0.68%)。结论:PBMV治疗二尖瓣狭窄是一种安全、有效的方法。Objective：To assess the efficacy and safety of percutaneous balloon Mitral valvuloplasty （PBMV） using the Inoue balloon.Method：Data from cardiac catheterization,echocardiography and cardiac functional status before and after PBMV were analysed in 1625 patients whose clinical informations had been relatively integrated since 1992,and the success rate and the complication incidence of PBMV were evaluated as well.Result：The technical success rate of PBMV was 98.71 percent.The average left atrial pressure （LAP） was 22.76±8.85 mmHg and （14.15±6.11）mmHg（P0.001）,left atrial diameter （LAD） （49.42±9.71）mm and （45.16±8.27）mm（P0.001）,Mitral valve area （MVA） （1.11±0.29）cm2 and （2.01±0.65）cm2（P0.001）,mean transmitral gradient （MTMG） 12.18±5.85 mmHg and 3.21±3.77 mmHg mmHg （P0.001）.There was complication in 96 cases（5.90%）,including initral regurgitation （MR） in 71 （4.37%）,cardiac tamponade in 13（0.80%）,systemic embolism in 9（0.55%） and other complications in 5 （0.31% ）.Complications leading to death in 2 cases （0.12 %） and the need for emergency surgical intervention in 11 cases （0.68%）.Conclusion：PBMV is an effective,safe,economic and mature treatment for mitral stenosis.

关 键 词：心瓣膜疾病 Inoue法 经皮球囊二尖瓣成形术 二尖瓣狭窄 

分 类 号：R542.5[医药卫生—心血管疾病]