国产思达机械瓣膜的临床应用与随访  

Clinical application and follow-up of domestic Sida mitral-mechanical valve

作　　者：邬晓臣[1] 欧阳辉[1] 张近宝[1] 岳琴[1] 辛东[1] 辛梅[1] 张宇兵[1] 

机构地区：[1]成都军区总医院心血管外科,成都610083

出　　处：《西南国防医药》2013年第10期1060-1062,共3页Medical Journal of National Defending Forces in Southwest China

基　　金：四川省卫生厅基金(100090)

摘　　要：目的探讨国产思达双叶机械瓣膜的临床应用价值。方法选取2010年6月～2011年6月我院心胸外科住院的符合病例纳人标准的270例风湿性心脏病患者，其中以应用国产思达机械瓣膜的二尖瓣替换术患者129例（单瓣置换67例，双瓣置换62例）为研究对象，以同期接受美敦力（ATS）双叶机械瓣膜二尖瓣替换术患者141例（单瓣置换73例，双瓣置换68例）为对照组。通过术后体表心动超声和彩色多普勒检查，观察两种人工心脏瓣膜相应型号瓣膜的血流动力学情况，运用二尖瓣压差半降时间（PHT）的方法获得有效瓣口面积（EOA）。结果两组病例术前指标无明显统计学差异，术后两组各死亡1例，思达组2例、对照组1例出现瓣周漏；术后6个月超声心动图检查随访，两组在Pmax、Pmean、Vmax、Vmean、PHT和VOA上比较无统计学差异。结论国产思达机械瓣膜的性能与ATS双叶机械瓣膜比较无显著差异，可替代其在临床推广使用。在临床应用和随访中能够达到较好的瓣膜功能。Objective To investigate the application value of domestic Sida mechanical valve. Methods Among the 270 patients with rheumatic heart disease who were hospitalized between June 2010 and June 2011,129 ones who underwent bicuspid valve replacement with the domestic Sida mechanical valve （ 67 cases of MV replacement and 62 ones of MV and AV replacement） were chosen as subjects. The 141 patients who received the replacement with ATS mechanical valve simultaneously were chosen as control group（73 cases of MV replacement and 68 ones of MV and AV replacement）. The hemodynamic situations of the two kinds of artificial bileaflet mechanical valves were observed through the examination of postoperative echocardiography and color Doppler. The effective orifice area（EOA）was calculated by the method of bicuspid valve pressure half time. Results There was no significant difference in the preoperative indexes between the two groups. After the operation, each group had one case of death. Perivalvular leakage occurred in 2 cases of the Sida group and in one of the control group. In the follow-up by echocardiography 6 months after the operation, there was no significant difference in Pmax,Pmean,Vmax,Vmean,PHT,and VOA between the two groups. Conclusion There is no significant difference in the function between domestic Sida mechanical valve and ATS mechanical valve.

关 键 词：思达机械瓣膜 心脏瓣膜替换术 机械瓣膜 血流动力学 

分 类 号：R541.2[医药卫生—心血管疾病]