二尖瓣成形术治疗二尖瓣关闭不全的临床研究  

Study on surgical mitral valvuloplasty for mitral regurgitation

作　　者：刘旭东[1] 王云[1] 季中华[1] 纳丽莎[1] 吴继红[1] 

机构地区：[1]宁夏医科大学总医院心脏外科,宁夏银川750004

出　　处：《宁夏医学杂志》2012年第10期955-956,共2页Ningxia Medical Journal

摘　　要：目的总结25例二尖瓣关闭不全患者行二尖瓣成形术的手术方法及效果。方法患者均在全麻低温体外循环下施行,采用瓣叶切除修复、瓣裂修复、交界缝合、腱索缩短、双孔二尖瓣成形、人工瓣环植入。手术前、后应用食道内超声心动图判断二尖瓣反流的原因和部位及手术治疗效果,术中采用左室注水加压试验初步判断二尖瓣成形的效果。术后随访主要依靠超声心动图。结果围术期死亡1例,死于恶性心律失常。术后心脏彩超显示,15例(60.00%)无二尖瓣返流,9例(36.00%)为轻微～轻度返流,左房、左室较术前明显缩小,心功能较术前明显改善。结论严格掌握手术适应征,针对不同瓣膜病变,运用合理的瓣膜成形技术,行二尖瓣外科修复疗效确切,术中左室注水试验及经食道超声心动图可为二尖瓣成形提供良好的技术支持。Objective To summarized 25 cases of mitral regurgitation who underwent mitral repair.Methods All patients underwent mitral repair under the hypothermic cardiopulmonary bypass.Surgical procedures included valve leaflets excision,valve defects repair,and guillotine commissurotome suture,chordae tendineae shortening,double-orifice repair and anulus ring implantation.Transesophageal echocardiography was used intraoperative procedures to assess the causes and locations of mitral regurgitation,and the repair outcomes.The left ventricular filling was used to judge primarily the repair results.Postoperative echocardiography was used for follow-up.Results There was one perioperative death due to the severe vital arrhythmia.Postoperative echocardiography showed that 15 patients（60.0 %） had no mitral regurgitation,9 patients（36.0%） little mild regurgitation.Heart function improved significantly compared with preoperative ones.Conclusion The good results could be obtained by applications of surgical indications and reasonable valve techniques.Intraoperative transesophageal echocardiography and left ventricular filling test can provide a good technical support for mitral valve repair.

关 键 词：二尖瓣成形术 二尖瓣关闭不全 

分 类 号：R654.2[医药卫生—外科学]