经皮球囊导管二尖瓣成形术治疗风湿性二尖瓣狭窄的临床疗效  

Clinical Effect of Percutaneous Balloon Mitral Valvuloplasty in Treatment of Rheumatic Mitral Stenosis

作　　者：吴建淮[1] 李小寒[1] 游向东[1] 陈丽华[1] 朱晓英 单江[1] 

机构地区：[1]浙江大学医学院附属第二医院,浙江杭州310009

出　　处：《浙江大学学报（医学版）》2000年第2期76-78,共3页Journal of Zhejiang University(Medical Sciences)

摘　　要：目的 :评价经皮球囊导管二尖瓣成形术 (PBMV)治疗风湿性二尖瓣狭窄 (MS)的临床疗效。方法 :采用Inoue法对 3 3 6例风湿性MS患者行PBMV。结果 :术后左房平均压由 3 .0 6± 1 .0 4kPa降至 1 .87± 0 .77kPa,二尖瓣跨瓣压差由 2 .1 1± 0 .2 1kPa降至 0 .8± 0 .0 8kPa,二尖瓣口面积由 0 .96± 0 .3 2cm2 增至 1 .81± 0 .5 2cm2 (P均 <0 .0 5 ) ,患者症状、心功能显著改善。术中无死亡 ,术后 48h死亡 1例 (0 .3 % ) ,死于低心排。心肌穿孔、心包填塞 7例 (2 % ) ,中度二尖瓣返流 6例(1 .7% ) ,医源性房间隔缺损 7例 (2 % )和脑梗塞 2例 (0 .5 % )。 1 0例再狭窄患者再次行PBMV成功。结论 :PBMV治疗风湿性MS有良好的临床疗效。Objective:To evaluate clinical effect of percutaneous balloon mitral valvuloplasty(PBMV) in treatment of rheumatic mitral stenosis(MS).Methods:By using Inoue technique PBMV was performed in 336 patients.Results:PBMV was successful in 330 cases of MS with effective rate of 98%,mean left atrial pressure decreased from 3.06±1.04 kPa to 1.87±0.77 kPa( P <0.01),mitral valve pressure gradient decreased from 2.11±0.21 kPa to 0.80±0.08 kPa( P <0.01),mitral valve area increased from 0.96±0.32 cm 2 to 1.81±0.52 cm 2( P <0.01),and the symptomatic appearance and cardiac function were significantly improved in these patients.There was no mortaliy during the procedure.One patient died 48 hours,after PBMV resulting from low cardiac output(0.3%).Main complications included perforation of cardiac wall with tamponade in 7 cases(2%),middle mitral regurgitation in 6(1.7%),iatrogenic atrial septal defect in 7 (2%) and cerebral embolism in 2(0.5%). PBMV was successfully performed again in 10 patients.Conclusion:In treatment of rheumatic MS PBMV has good clinical effects,and even for critical,complex MS or restenosis after PBMV it may also be one of valuble choice.

关 键 词：风湿性心脏病 二尖瓣狭窄 气囊扩张术 PBMV 

分 类 号：R654.2[医药卫生—外科学]