MDCT对保留二尖瓣全瓣心脏生物瓣膜替换术后心功能的评价  

Cardiac function assessment after bioprosthetic valve replacement with mitral valve preservation by MDCT

作　　者：吴洪坤 杨庆军 李康 陈灏 严宇 罗永金 余扬 喻鹏凌 

机构地区：[1]重庆市人民医院心血管外科,400013

出　　处：《重庆医学》2017年第22期3060-3062,共3页Chongqing medicine

基　　金：重庆市医学科研计划项目(2012-2-195)

摘　　要：目的研究多层螺旋CT(MDCT)对保留二尖瓣心脏生物瓣膜替换术后心功能的评价。方法选择2012年5月到2014年2月到该院就诊的适合二尖瓣心脏生物瓣膜替换术的患者共35例,将其分为两组,A组术中保留二尖瓣全瓣及瓣下结构,B组术中不保留二尖瓣瓣下结构。术前,术后10d行MDCT检查,评价左心室功能。结果两组病例术前MDCT对比,A组和B组左心室舒张末期容积(EDV)、左心室收缩末期容积(ESV)、射血分数(EF)、每搏输出量(SV)比较差异无统计学意义(P>0.05)。A组术后10dMDCT的结果 EDV、ESV、EF分别为(106.25±8.83)mL、(35.75±4.37)mL、(54.48±4.23)%,B组分别为(113.42±9.22)mL、(38.63±3.40)mL、(51.63±4.71)%,两组比较差异均有统计学意义(P<0.05),而两组间SV比较差异无统计学意义(P>0.05)。结论保留二尖瓣全瓣的心脏生物瓣膜替换术,技术安全可行,且有效地保护了心脏术后的左心室功能。Objective To investigate the assessment of multi-detector spiral CT on the cardiac function after bioprosthetic valve replacement with mitral valve preservation. Methods Thirty-five patients suitable for undergoing bioprosthetic mitral valve replacement in our hospital from May 2012 to February 2014 were randomly divided into 2 groups：group A（experimental group, in- traoperative preservation of mitral valve and subvalvular structure during,n： 16） and group B （control group, without intraopera- tive preservation of subvalvular structure of mitral valve,n = 19）. MDCT before operation and on postoperative 10 d was performed for evaluating the left ventricular function. Results In the comparison of preoperative MDCT,the end diastolic vetocity（EDV） ,end systolic velocity（ESV）,ejection fraction（EF） and stroke volume（SV） had no statistical difference between the group A and B. In MDCT results on postoperative 10 d,EDV,ESV and EF in the group A were 113.42±9.22）mL,（38.63±3.40）mL and （51.63± 4.71）%,which in the group B were（113.42±9.22）mL, （38.63±3.40）mL and（51.63=[=4.71）% respectively, the difference was statistically significant（P〈0.05）, but SV had no statistical difference between the two groups （P〉 0.05）. Conclusion The bioprosthetic valve replacement with mitral valve preservation is safe and feasible in technology,moreover effectively protects the postoperative left ventricular function.

关 键 词：二尖瓣 心脏功能试验 体层摄影术 螺旋计算机 心脏生物瓣膜 保留二尖瓣全辫 

分 类 号：R654.2[医药卫生—外科学]