人工腱索植入术对二尖瓣置换术后患者左心功能的影响  

Effect of artificial chordae implantation in patients with mitral valve replacement on left ventricular function

作　　者：刘石健骢 马东亮[1] 蔡国华[1] 亓峰[1] 刁力为[1] 孙振东[1] 张庆华[1] 韩思扬 吴乃石[1] 

机构地区：[1]哈尔滨医科大学附属第二临床医学院心外科3病房,150086

出　　处：《心肺血管病杂志》2014年第1期13-16,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探讨人工腱索植入术对风湿性心脏病患者二尖瓣置换术后左心功能的影响。方法:回顾性分析50例因患风湿性心脏病而需要进行二尖瓣置换手术(mitral valve replacement,MVR)患者的临床资料,根据术中对二尖瓣不同处理方式分为两组:A组(n=26),切除全部瓣膜及瓣下结构组;B组(n=24),为需切除全部瓣膜及瓣下结构的患者实行人工腱索植入术重建瓣下结构。分别于术后3个月对患者进行彩色多普勒超声心动图检查,测量患者左心功能,比较两组间各项指标的差别。结果:术后3个月B组患者左心室射血分数(LVEF)改变优于A组(P<0.05)。结论:二尖瓣置换术中,人工腱索植入重建瓣下结构的技术安全有效,对患者术后短期左心功能的恢复有良好改善,长期效果仍需进一步观察。Objective：To study the effect of artificial chordae implantation on left ventricular function in patients with rheumatic heart disease after mitral valve replacement （MR）.Methods：We retrospectively analyzed the clinical data of 50 patients with rheumatic heart disease and underwent mitral valve replacement surgery.They were divided into two groups based on the different treatment during mitral valve replacement.For 26 patients in group A,both leaflets and subvalvular apparatus were excised,while for 24 patients were rebuilt subvalvular apparatus during MVR with artificial chordae in group B.The indexes of left ventricular function in two groups were detected by using the color Doppler sonography 3 months after the surgery and compared with each other.Results：The left ventricular ejection fraction （LEF） in group A,3 months after the surgery was significantly higher than that in group B.Conclusion：Artificial chordae implantation in MR is a safe and effective surgical technique and improve left ventricular function in a short-term.Long-term result and benefit remains to be seen.

关 键 词：风湿性心脏病 二尖瓣置换 人工腱索 瓣下结构 左心室功能 

分 类 号：R54[医药卫生—心血管疾病]