79例经皮球囊二尖瓣成形术患者10年远期疗效评价  

Evaluation on long term results of percutaneous mitral balloon valvuloplasty

作　　者：陈纪言[1] 周颖玲[1] 李光[1] 黄奕高[1] 黄涛[1] 陈传荣[1] 

机构地区：[1]广东省心血管病研究所

出　　处：《中华心血管病杂志》1999年第2期124-126,共3页Chinese Journal of Cardiology

摘　　要：目的评价二尖瓣球囊成形术（ＰＢＭＶ）后１０年以上的远期疗效。方法对７９例ＰＢＭＶ患者进行严格的术后追踪随访，包括超声心动图和临床心功能评价。平均随访时间（１１．２±１．１）年。结果ＰＢＭＶ术后二尖瓣口面积（ＭＶＡ）显著扩大，为（１．０９±０．３２）ｃｍ２与（２．０４±０．４３）ｃｍ２，Ｐ＜００１；随访１０年，ＭＶＡ逐渐减小至（１．４７±０．３６）ｃｍ２，Ｐ＜０．０１；再狭窄率为３９．２％。ＰＢＭＶ术后心功能改善１个级别以上者占９７．５％。术后１０年随访心功能仍然维持在Ⅰ～Ⅱ级而未再次行介入或心脏手术者占７７．２％。术后新出现或轻度加重的二尖瓣反流以及新出现的房间隔分流分别为１２．６％和７．９％，均未引起明显的血流动力学障碍，长期保持良好的心功能。结论ＰＢＭＶ术后１０年以上临床远期疗效良好，未见严重并发症。Objective This study was sought to assess long term results (more than ten years) after successful percutaneous mitral balloon valvuloplasty.Method From November 1985 to September 1988, eighty four patients underwent PBMV successfully in Guangdong Provincial Cardiovascular Institute, of which seventy nine patients had clinical and echocardiographic evaluation initially and throughout the 10 year follow up. Results Before and after PBMV and at follow up, mean mitral valve areas were 1.09±0.32 cm 2 vs 2.04±0.43 cm 2 vs 1.47 ± 0.36 cm 2 respectively (before vs after P <0.01, after vs follow up P <0.01, before vs follow up P < 0.01) . Restenosis rate was 39.3% at the end of 10 year follow up. There were seventy seven (97.5%) patients who had at least I class improvement in cardiac function just after PBMV. At the end of 10 year follow up, 61 patients (77.22%) were still in NYHA class Ⅰ or Ⅱ without mitral operation or repeated valvuloplasty. There were 12.6% and 7.9% of patients had new mitral regurgitations and atrial septal defects respectively, but none experienced serious dynamic impairment. Conclusion Percutaneous balloon mitral valvuloplasty can achieve excellent and sustained long term results without serious complications in selected patients.

关 键 词：二尖瓣狭窄 气囊扩张术 心脏功能试验 PBMV 

分 类 号：R654.2[医药卫生—外科学]