重度二尖瓣狭窄患者经皮球囊二尖瓣成形术后妊娠的随访  

Follow up of pregnancy after percutaneous balloon mitral valvuloplasty(PBMV) in women of child-bearing age with severe rheumatic mitral stenosis

作　　者：戴剑[1] 王林林[1] 吴晓馗[1] 

机构地区：[1]南京市胸科医院心脏科,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2012年第8期1110-1112,共3页Journal of Nanjing Medical University(Natural Sciences)

摘　　要：目的:观察经皮球囊二尖瓣成形术(percutaneous balloon mitral valvuloplasty,PBMV)在育龄期风湿性心脏病、二尖瓣狭窄患者中的安全性、可行性及术后妊娠对心功能、手术效果的影响。方法:回顾性分析本院自2000年1月～2011年12月9例行PBMV的育龄期风湿性心脏病、重度二尖瓣狭窄女性患者,观察术前、术后及孕期血流动力学变化,出院后随访2.5～7.0年。结果:手术前后左心房压力、二尖瓣跨瓣压差及二尖瓣瓣口平均面积差异均有统计学意义。9例患者无1例手术操作相关并发症。术后所有患者均正常妊娠,孕期随访患者心功能、二尖瓣瓣口面积无明显变化。孕前及产后二尖瓣跨瓣压差、瓣口平均面积无显著差异。所有患者均自然分娩,胎儿Apgar评分9～10分。结论:PBMV术在重度二尖瓣狭窄的育龄期青年女性中具有良好的耐受性、安全性及可行性。Objective：To investigate the safty and feasibility of percutaneous balloon mitral valvuloplasty（PBMV） on women of child-bearing age with severe rheumatic mitral stenosis and the effect of subsequent pregnancy on cardiac function.Methods：PBMV was made in 9 female patients（mean age 24.6 years） admitted in our hospital since January 2000 to December 2011,whose clinical and echo cardiographic evaluation were obtained with a follow-up of 2.5～7.0 years.Results：The procedure was successful in all 9 patients,with no severe complication.There was significant difference in left atrial mean pressure,mitral valve pressure gradient and mitral valve area after the procedure.All patients subsequently got pregnant and had normal vaginal deliveries.The children had normal growth and development with the Apgar score of 9～10.No signifcant change was observed in all echocardiographic parameters and cardiac function before pregnancy and after delivery.Conclusion：In women of child-bearing age with symptomatic mitral stenosis,PBMV is feasible,safe and effective.

关 键 词：经皮球囊二尖瓣成形术 二尖瓣狭窄 妊娠 随访研究 

分 类 号：R654.2[医药卫生—外科学]