全软成形环与缘对缘瓣膜成形术在心脏瓣膜关闭不全成形术中的疗效比较  

A Comparative Study on the Effect of Fully Flexible Prosthetic Ring and Edge to Edge Valvuloplasty in the Treatment of Cardiac Valve Closure Insufficiency

作　　者：王向辉[1] 杨雅伦 黄江平[1] 崔丰和[1] 钱海云[1] 张军[2] 

机构地区：[1]荆州市中心医院胸外科,湖北荆州434000 [2]武汉大学人民医院胸外科,湖北武汉430000

出　　处：《现代生物医学进展》2016年第19期3703-3706,共4页Progress in Modern Biomedicine

基　　金：湖北省自然科学基金项目(201006809;2011CHB018)

摘　　要：目的:观察和比较全软成形环与缘对缘瓣膜成形术在心脏瓣膜关闭不全成形术中的疗效。方法:回顾性研究我院行心脏瓣膜关闭不全成形术患者80例,随机分为Ⅰ组与Ⅱ组,每组各40例。第Ⅰ组患者在行心脏瓣膜关闭不全成形术中使用全软成形环进行治疗,第Ⅱ组患者在手术过程进行缘对缘瓣膜成形术。比较治疗前后两组患者二尖瓣口、二尖瓣环面积和收缩期及舒张期二尖瓣环周径、左心室内径、心搏出量、射血速率、射血时间及临床有效率。结果:治疗后,两组二尖瓣形态、左心室内经、心搏出量、射血速率及射血时间均较治疗前有所改善(P<0.05);且与第Ⅱ组相比,第Ⅰ组患者二尖瓣口面积、心搏出量及射血速率较大,二尖瓣环的面积、收缩期及舒张期二尖瓣环周径、左心室内径较小,射血时间明显缩短(P<0.05)。第Ⅱ组治疗总有效率为95%,较第Ⅰ组(62.5%)显著升高,差异具有统计学意义(P<0.05)。结论:与缘对缘瓣膜成形术相比,全软成形环在心脏瓣膜关闭不全成形术中的疗效更好,其机制可能与增大二尖瓣口面积、心搏出量及射血速率,减小二尖瓣环的面积、收缩期及舒张期二尖瓣环周径、左心室内径,缩短射血时间有关。Objective： To observe and compare the effect of Fully Flexible prosthetic Ring and edge to edge valvuloplasty in the treatment of cardiac valve closure insufficiency. Methods： 80 cases of patients with cardiac valve closure insufficiency from our hospital were selected and randomly divided into the group Ⅰ and the group Ⅱ with 40 cases in each group. The group Ⅰwas treated by fully flexible prosthetic ring in cardiac valve closure insufficiency and the group Ⅱ was treated by edge to edge valvuloplasty. The mitral stenosis, mitral annular area and mitral systolic and diastolic circumferential diameter, left ventricular diameter stroke volume, ejection rate and radiation time blood and clinical efficiency were compared before and after treatment by SPSS19.0. Results： Compared with before treatment, the mitral valve shape, left ventricle, stroke volume, ejection rate and ejection time in both groups were significantly improved（P〈0.05）. Compared with group Ⅱ, the mitral valve orifice area stroke volume and ejection rate were higher in the group I, and the mitral annular area, systolic and diastolic mitral annulus diameter, left ventricular diameter smaller and shoot blood time were significantly shorter（P〈0.05）. The total effective rate was 95% in the group Ⅱ, which was higher than 62.5% in the group I, and the difference was statistically significant（P〈0.05）. Conclusion： Compared with the edge to edge valvuloplasty, fully flexible prosthetic ring had better efficacy in the treatment of cardiac valvular insufficiency, the mechanism might be related to the increase of the mitral valve orifice area,stroke volume and ejection rate, the decrease of mitral annular area, systolic and diastolic mitral annulus diameter, left ventricular diameter and the shorten of ejection time.

关 键 词：全软成形环 缘对缘瓣膜成形术 心脏瓣膜关闭不全成形术 

分 类 号：R542.5[医药卫生—心血管疾病]