经食管实时三维超声心动图对二尖瓣成形术疗效的评估  

The Evaluation of Clinical Efficacy of Real-time Three-dimensional Transesophageal Echocardiography in Mitral Valve Repair

作　　者：纳丽莎[1] 王芳[1] 周丽[1] 叶晶晶[1] 王云[2] 

机构地区：[1]宁夏医科大学总医院心脏中心功能检查部超声心动图室,宁夏银川750004 [2]宁夏医科大学总医院心脏中心心脏大血管外科,宁夏银川750004

出　　处：《宁夏医学杂志》2016年第7期592-594,共3页Ningxia Medical Journal

基　　金：宁夏卫生计生委重点科研课题(2014NW015)

摘　　要：目的探讨经食管实时三维超声心动图(RT-3D-TEE)在二尖瓣成形术(MVR)疗效评估中的临床应用价值。方法选择二尖瓣脱垂(MVP)伴中度以上返流拟行MVR患者30例,术前与术后均行RT-3DTEE检查,并应用二尖瓣定量分析(MVQ)软件分析二尖瓣瓣环及瓣叶的相关参数。结果 MVR术前,RT-3DTEE能够量化评价二尖瓣装置结构;二尖瓣瓣环在三维平面内的周长,二尖瓣瓣环的二维面积、周长、环高度、瓣环前外侧至后内侧平面直径、前后直径均较术前减小,差异有统计学意义(P<0.05);二尖瓣前、后叶在三维平面内的面积,二尖瓣后叶在三维平面内的长度,MVP最大容积,MVP最大高度较术前减小,差异有统计学意义(P<0.05);二尖瓣前外侧至后内侧接合的二维弧长较术前减小,差异有统计学意义(P<0.05);二尖瓣前、后瓣叶角度较术前增加,差异无统计学意义(P>0.05);二尖瓣前叶在三维平面内的长度,主动脉瓣与二尖瓣之间角度较术前减小,差异无统计学意义(P>0.05)。结论 RT-3D-TEE在MVR患者中能为术前的手术方案精确设计提供重要参考信息,术后能定量评价手术效果。Objective Discussing the clinical efficacy of mitral valve repair （MVR） using real - time three - dimensional transesophageal echocardiography（ RT - 3D - TEE）. Methods Thirty patients with mitral valve prolapse（MVP） were selected ,which referred for MVR ,because they had more than moderate mitral regurgitation.. All patients were undergone RT -3D -TEE and mitral valve qutification before and after MVR. Results RT -3D -TEE could quantitatively evaluate mitral valve before MVR. After the surgery, the circumference of mitral annulus（ C3D）,the area and circumference of the mitral annulus （A2D, C2D）, the annulus the biggest height （H）, the anterolateral to posteromedial diameter （DalPm） and the anterior to posterior diameter of the mitral annulus （DAP） became significantly smaller （ P 〈 0.05 ）. After the surgery, the area of the three - dimensional view of anterior and posterior leaflet （ A Ant, A Post）, the length of the posterior leaflet（ L Post）, the largest volume of leaflet prolapse （V Prol） and the maximal height of leaflet pro- lapse （H Prol ） became smaller, the differences were statistically significant（ P 〈 0. 05 ）. In the two -dimensional projection plane, the arc length of anterolateral to posteromedial coaptation （Lalpm） was significantly smaller postoperatively, the difference was statistically signifi- cant（ P 〈 0.05 ）. Compared with the preoperative,the angle of anterior leaflet and posterior leaflet （ θAnt, θPost） were increased, （ P 〉 0.05 ）. Compared with the preoperative, the length of the three - dimensional view of anterior leaflet （ L3D Ant） and the angle of aortic and mitral valve（θ） were increased （P 〉 0.05 ）. Conclusions RT- 3D -TEE could provied important reference information for desig- ning surgery program before MVR, and it could also quantitatively evaluate clinical efficacy of mitral valve.

关 键 词：超声心动描记术 三维 经食管 二尖瓣成形术 

分 类 号：R540.45[医药卫生—心血管疾病]