经皮二尖瓣球囊成形术治疗风湿性二尖瓣狭窄疗效的初步探讨  

Study on the effect of percutaneous balloon mitral valve in the treatment of rheumatic mitral stenosis

作　　者：赵明[1] 刘志平[2] 王坚[2] 

机构地区：[1]内蒙古医科大学研究生院,内蒙古自治区呼和浩特市010110 [2]内蒙古医科大学附属医院心脏大血管外科

出　　处：《中国心血管病研究》2016年第10期926-929,共4页Chinese Journal of Cardiovascular Research

摘　　要：目的 探讨经皮球囊二尖瓣成形术（PBMV）治疗风湿性二尖瓣狭窄的近期疗效.方法 将内蒙古医科大学附属医院2013年9月至2016年1月14例应用PBMV治疗的风湿性二尖瓣狭窄患者按照年龄分为A组（年龄＜60岁）和B组（年龄≥60岁）.两组分别用心导管测定患者PBMV前后的左心房压力、肺动脉压力,心脏超声评价PBMV前后二尖瓣口面积、二尖瓣口血流速度、二尖瓣返流面积及左房内径、左室舒张末径、右房内径、右室舒张末径、左室每搏输出量、左室射血分数等指标.将两组数据进行统计分析.结果 PBMV成功率100％,无围手术期并发症及死亡病例.术后即刻二尖瓣口面积A组为（2.22±0.39）cm2,B组为（1.74±0.44）cm2,P=0.059;术后二尖瓣口面积A组（1.93±0.39）cm2,B组（1.71±0.48）cm2,P=0.463.术后即刻二尖瓣血流速A组（1.34±0.57）m/s,B组（1.29±0.05）m/s,P=0.825;术后二尖瓣血流速A组（151.80±37.01）m/s,B组（171.43±40.78）m/s,P=0.414.术后肺动脉压A组（33.00±12.91）mm Hg,B组（19.00±0.00）mm Hg,P=0.222.术后左心房压A组（14.17＋8.26）mm Hg,B组（15.71＋9.32）mm Hg,P=0.759.A组、B组在PBMV前后所有参数比较均未见统计学差异（P＞0.05）.结论 PBMV治疗风湿性二尖瓣狭窄有效,老年患者（≥60岁）亦可以从该术式获益.Objective To investigate the short-term efficacy of percutaneous balloon mitral valve（PBMV） in the treatment of rheumatic mitral stenosis. Methods In our hospital from September 2013 to January 2016, 14 patients of rheumatic mitral stenosis received percutaneous balloon mitral valvuloplasty （PBMV）, and according to age were divided into group A （age〈60 years） and group B （aged≥60 years）. The variables in two groups were measured respectively before and after PBMV. These variables included left atrial pressure and pulmonary artery pressure by heart catheter test, mitral valve orifice area, mitral valve orifice flow velocity, mitral valve reverse flow area and left atrial diameter, left ventricular end diastolic diameter, right atrial and right ventricular end diastolic diameter, left ventricular stroke volume index of output, left ventricular ejection fraction by ultrasound cardiogram evaluation. All data were analyzed by statistics. Results The success rate of PBMV was 100% with no perioperative complications and death. The mitral orifice area immediately after PBMV in group A was（2.22±0.39）cm2, and the one in group B was （1.74±0.44）cm2, P=0.059. The mitral orifice area after PBMV in group A was （1.93± 0.39）cm2, and the one in group B was（ 1.71±0.48 ）cm2, P=0.463. The mitral valve blood flow velocity immediately after PBMV in group A was （1.34±0.57）m/s, and the one in group B was （1.29±0.05）m/s, P=0.825. The mitral valve blood flow velocity after PBMV in group A was （151.80±37.01）m/s, and the one in group B was （171.43± 40.78）m/s, P=0.414. The pulmonary artery pressure after PBMV in group A was （33.00±12.91）mm Hg, and the one in group B was （19.00±0.00）mm Hg, P=0.222. The left atrial pressure after PBMV in group A was （14.17± 8.26）mm Hg, and the one in group B was（ 15.71±9.32）mm Hg, P=0.759. All variables showed no statistically significant difference （P〉0.05） between group A and group B before and after PBMV. Conclusion PBMV is

关 键 词：风湿性二尖瓣狭窄 经皮球囊二尖瓣成形术 年龄 

分 类 号：R654.2[医药卫生—外科学]