二尖瓣成形术在二尖瓣反流治疗中的疗效评价  

Clinical analysis of mitral valvuloplasty in patients with mitral regurgitation

作　　者：熊峰[1] 冯坤[1] 王淑珍[1] 刘春霞[1] 张丽娟[1] 徐敏[1] 

机构地区：[1]四川省成都市心血管疾病研究所成都市第三人民医院心内科,成都610031

出　　处：《岭南心血管病杂志》2016年第5期569-572,共4页South China Journal of Cardiovascular Diseases

基　　金：成都市卫生局青年基金项目(项目编号:201124)

摘　　要：目的探讨二尖瓣成形术在二尖瓣反流治疗中的疗效。方法选取2011年1月至2014年7月在成都市第三人民医院行二尖瓣成形术的二尖瓣反流患者42例。手术方式包括人工瓣环置入,瓣叶部分切除,腱索修复、转移,人工腱索置入,缘对缘缝合技术等。术中左心室注水试验及经食道超声心动图检查评估即时效果,术后超声心动图随访二尖瓣反流、左心大小及左心室功能。结果 42例成功行二尖瓣成形术患者中1例围术期死亡。术后1个月、1年与术前相比,左心房内径(LAD)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)均差异有统计学意义(P<0.05);左心室射血分数(LVEF)在术后1个月变化不明显,但在术后1年监测中比术前增高,差异有统计学意义(P<0.05)。二尖瓣无明显反流33例,微量反流5例,轻度反流3例。结论二尖瓣成形术是治疗二尖瓣反流的可靠方法 ,改善了左心结构重构及功能。Objectives To explore the clinical effect on mitral regurgitation in patients with mitral valvuloplasty. Methods This study included 42 patients with mitral regurgitation after mitral valvuloplasty from January 2011 to July 2014 in The Third people＇s Hospital of Chengdu. Multiple technologies were used, such as annular ring implantation, partial resection of the leaflet, chordae repair, chordae transposition, artificial chordae replacement, edge to edge, etc. The effects of valvular repair were evaluated by saline injection test and transesophageal echocardiography during operation.Mitral regurgitation,diameter of left heart and left ventricular systolic function were carried out by echocardiography for follow-up care. Results One patient died postoperatively due to low cardiac output. Left atrial diameter （LAD）, left ventricular end-diastolic diameter （LVEDD） and left ventricular end-systolic diameter （LVESD） were reduced at 1 and 12 months after mitral valvuloplasty （P〈0.05） . Left ventricular ejection fraction （LVEF） did not change significantly after 1 month, but increased 12 months after surgery. There were 33 cases without mitral regurgitation, 5 cases with slight regurgitation, 3 cases with mild regurgitation. Conclusions Mitral valvuloplasty is a reliable method for the treatment of mitral regurgitation and can reverse the cardiac remodeling.

关 键 词：二尖瓣成形术 二尖瓣反流 超声心动图 

分 类 号：R542.51[医药卫生—心血管疾病]