经皮穿刺二尖瓣球囊成形术135例临床应用  

Clinical analysis of the percutaneous blloon mitral valvuloplasty in 135 cases

作　　者：沙勇[1] 马维华[1] 贾绍斌[1] 陈树兰[1] 张金莉[1] 

机构地区：[1]宁夏医学院附属医院

出　　处：《宁夏医学杂志》1999年第5期263-264,共2页Ningxia Medical Journal

摘　　要：目的研究总结１３５例经皮穿刺二尖瓣球囊成形术（ＰＢＭＶ）的成功率、效果及并发症。方法采用改良Ｉｎｏｕｅ单球囊技术对１３５例风湿性二尖瓣狭窄（ＭＳ）患者行ＰＢＭＶ。结果术后血液动力学显著改善，左心房平均压（ＭＬＡＰ）从２３．５±６．２降至１０．７±５．１ｍｍＨｇ（Ｐ＜０．００１），跨二尖瓣压力阶差（ＭＶＰＧ）从１９．４±６．８降至３．８±２．９ｍｍＨｇ（Ｐ＜０．００１），二尖瓣口面积（ＭＶＡ）从１．０３±０．３２ｃｍ２扩大到２．１４±０．２８ｃｍ２（Ｐ＜０．００１），左心房内径（ＬＡＤ）从４７．７±６．８ｍｍ缩小至４０．２±６．５ｍｍ（Ｐ＜０．０１）；有１例手术未成功，无１例发生严重并发症。结论表明只要术前准备充分，术中仔细操作，ＰＢＭＶ已成为治疗风湿性ＭＳ安全有效的方法。Objectives This study summariazes the ratio of success,the effect and the complications about percutaneous balloon mitral valvuloplasty (PBMV) in 135 patients.Methods The operation of PBMV was performed with improved Inoue technique in 135 patients with rhumatic mitral stenosis (MS).Results Most patients had a significant improvement of hemodynamics after the operation:the mean left atrial pressure (MLAP) was decreased from 23.5±6.2 to 10.7±5.1mmHg ( P <0.001),transmitral pressure gradient (MVPG) was decreased from 19.4±6.8 to 3.8±2.9mmHg ( P <0.001),mitral valve area (MVA) was increased from 1.03±0.32 to 2.14±0.28cm 2( P <0.001),and left atrial diameter (LAD) was reduced from 47.7±6.8 to 40.2±6.5mm( P <0.01).One case was unsuccessful,in whom the valve could not be crossed.There were no severe complications,such as cardiac tamponade,severe MR,embolism or ventricular fibrillation.Conclusion PBMV is a safe and effective method for treating rhumtic MS provided that the operater should pay great attention to handle every stage before and in the procedure

关 键 词：球囊成形术 二尖瓣狭窄 PBMV 

分 类 号：R654.2[医药卫生—外科学]