Cosgrove环在二尖瓣成形术中的应用  

Clinical practice of Cosgrove-Edwards Annuloplasty System in mitral valve plasty surgery

作　　者：张卫[1] 郭震 叶伟[1] 

机构地区：[1]上海交通大学附属胸科医院,上海200030

出　　处：《现代中西医结合杂志》2010年第27期3413-3415,共3页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的观察Cosgrove环治疗二尖瓣反流的效果。方法对100例植入Cos-grove人工瓣环的病例进行多项指标测试,并与同期完成的55例Carpentier环做对照。结果 Cos-grove环与Carpentier环都有纠正二尖瓣反流的作用,纠治反流的程度2组间无显著性差异(P>0.05)。术后Cosgrove环的弹性变化率(18.97±5.32)%,明显优于Carpentier环的(11.45±5.21)%(P<0.01)。术后心功能的改变Cosgrove环与Carpentier环比较无显著性差异(P均>0.05)。Cosgrove环组术前、术后的二尖瓣有效瓣口面积及舒张期最大血流速度无显著差异(P>0.05);Carpentier环组术后二尖瓣有效瓣口面积较术前缩小,舒张期最大血流速度较术前增大(P<0.05)。2组术后左室流出道(LVOT)收缩期最大血流速度和主动脉瓣环与二尖瓣瓣环平面夹角(AM角)较术前均无显著改变(P均>0.05)。结论应用Cosgrove环治疗二尖瓣反流的效果明显。与Carpentier环相比,Cosgrove环由于弹性不同,对二尖瓣口的面积及血流速度影响较小,可以避免瓣膜狭窄的发生。Objective It is to evaluate the hemodynamic efficacy of the Cosgrove ring in the surgical management of mitral valve regurgitation.Methods Some indexes were used in 100 cases underwent Cosgrove ring annuloplasty and 55 cases underwent mitral annuloplasty with Carpentier Physio ring as control groups.Results Mitral valve insufficiency was corrected satisfactorily with Cosgrove ring and Carpentier ring and there were no statistical differences between two groups（P〈0.05）.The elasticity of mitral annulus postoperatively in Cosgrove group（（18.97±5.32）%） is better than that in Carpentier group（（11.45±5.21）%）（P〉0.01）.There were no differences between the Cosgrove ring and the Carpentier ring in terms of the improvement of ventricular function（P〉0.05）.There were no significant changes before and after Cosgrove ring operation in effective orifice area of mitral valve and maximum flow velocity（Vmax） in diastole（P〈0.05）.Contrarily,after the Carpentier ring operations the effective orifice area was reduced and the Vmax in diastole was increased（P〈0.05）.There were no significant changes in Vmax in systole of left ventricular outflow tract and aorto-mitral angle after operation in both groups（P〉0.05）.Conclusion Cosgrove-Edwards Annuloplasty System is effective for repair of mitral valve insufficiency.Compared with the Carpentier ring,its influences in atrioventricular orifice area and trans valvular flow is rare due to the different flexibility.Thus the Cosgrove is beneficial to avoid the valve stenosis.

关 键 词：二尖瓣环成形术 二尖瓣反流 Cosgrove环 Carpentier环 

分 类 号：R654.2[医药卫生—外科学]