二尖瓣后叶三角形切除成形术的疗效分析  

Long term outcomes of posterior leaflet triangular resectionvalvuloplasty formitral valve regurgitation

作　　者：乔瑞国 黄信生[1] 汪川[1] 张帆[1] 白辰[1] 李京倖[1] 

机构地区：[1]北京市心肺血管疾病研究所首都医科大学附属北京安贞医院心外科,100029

出　　处：《中华胸心血管外科杂志》2017年第10期580-582,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：北京市属医院科研培育计划项目（PZ2017018）

摘　　要：目的 探讨二尖瓣后叶三角形切除术远期疗效,为临床治疗提供参考.方法 回顾性分析2008年3月至2016年12月我院61例二尖瓣成形术患者的术前及术后随访资料,30例二尖瓣后叶三角形切除术（研究组）,31例二尖瓣后叶矩形（楔形）切除成形术（对照组）,比较术前、出院和随访时患者心功能相关指标及二尖瓣反流情况.结果 随访3~106个月,平均（42 ±34）个月,左心房、左心室径缩小（P〈0.05）,NYHA心功能明显改善.随访期间研究组出现二尖瓣中度反流1例、心律失常1例.对照组死亡1例、二尖瓣中度反流2例、心律失常1例.研究组免再反流比例（97 ±6）%,对照组免再反流比例（97 ±4）%.两组间差异无统计学意义.两组术后及随访均未出现SAM征.结论 二尖瓣后叶三角形切除成形术是一种更简单、更易行、远期疗效也较好的手术方法,与矩形切除成形术的远期疗效无明显不同.Objective To explorethe long-term prognosis of the triangular resectionvalvuloplasty for posterior mitral valve prolapse and provide a reference for the clinical treatment.Methods We retrospectively analyzed the clinical data of 61 pa-tients with posterior mitral valve prolapse underwent the mitral valvuloplasty in our hospital from Match 2008 to December 2016.30 patients who underwent triangular resection for posterior mitral valve prolapse.31 patients who underwentstandard quadrangular resection.The cardiac functional parameters and condition of mitral regurgitation were compared among the period of preoperation,discharging and follow-up.Results The mean follow-up period was 42 ±34（3-106）months.left atrium and left ventricular diameter were decreased（P〈0.05）.Inresrarch group,there was 1 patient who have moderate regurgitation,ar-rhythmia is one.In control group,there was arrhythmia in 1 cases,moderate regurgitation in 2 cases and death in 1 cases.Rate of freedom from reregurgitation was（97 ±6）% in research group and was（97 ±4）% in control group.There was no SAM in two groups.There were no significant differences of survival or risk of reoperation.There was a statistic difference of NYHA classification of cardiac function in the phase of follow-up than that of discharging（P〈0.05）.Conclusion Triangular resec-tion of a prolapsed posterior mitral leaflet is a simplified,reliable, reproducible, and durable procedure,like quadrangular re-section of a prolapsed posterior leaflet.

关 键 词：二尖瓣脱垂 二尖瓣关闭不全 二尖瓣成形术 

分 类 号：R654.2[医药卫生—外科学]