应用自体心包扩大三尖瓣前叶联合人工瓣环成形治疗重度三尖瓣关闭不全  

Application of autologous pericardium enlargement of anterior tricuspid leaflet combined with artificial valve annuloplasty in the treatment of severe tricuspid insufficiency

作　　者：朱伯卫[1] 陈凯明[1] 赖锋华[1] 刘浪[1] 林世廷[1] 陈泽科[1] ZHU Bo-wei;CHEN Kai-ming;LAI Feng-hua;et al.(Guangdong Gaozhou People＇ s Hospital, Gaozhou 525200, Chin)

机构地区：[1]广东省高州市人民医院,525200

出　　处：《中国实用医药》2018年第11期11-12,共2页China Practical Medicine

摘　　要：目的分析应用自体心包扩大三尖瓣前叶联合人工瓣环成形治疗重度三尖瓣关闭不全的效果。方法 60例重度三尖瓣关闭不全患者,均展开自体心包扩大三尖瓣前叶联合人工瓣环成形治疗,观察患者的手术情况,并对比患者治疗前及术后1年Tei指数、肺动脉收缩压(PASP)以及右心房变化情况。结果 60例重度三尖瓣关闭不全患者均顺利完成手术,无死亡病例,手术后通过超声检查发现,存在三尖瓣轻度关闭不全患者7例,占比为11.67%;存在三尖瓣微量关闭不全患者9例,占比为15.00%。60例重度三尖瓣关闭不全患者术后1年的Tei指数、PASP和右心房与治疗前比较,差异具有统计学意义(t=16.56、12.10、11.76,P<0.05)。结论重度三尖瓣关闭不全应用自体心包扩大三尖瓣前叶联合人工瓣环成形治疗的临床疗效可观,值得推广。Objective To analyze the effect of autologous pericardium enlargement of anterior tricuspid leaflet combined with artificial valve annuloplasty in the treatment of severe tricuspid insufficiency.Methods A total of 60 severe tricuspid insufficiency patients all treated with autologous pericardium enlargement of anterior tricuspid leaflet and artificial valve annuloplasty,and their surgical condition was observed.The changes of Tei index,pulmonary artery systolic pressure（PASP）and right atrium before treatment and after 1 year of treatment was compared.Results 60 cases of severe tricuspid insufficiency were all successfully completed,and no death case was found.After operation,ultrasound examination revealed that there were 7 patients with mild tricuspid regurgitation,accounting for 11.67%,and 9 patients with minim tricuspid regurgitation,accounting for 15.00%.The difference in Tei index,PASP and right atrium of 60 patients with severe tricuspid insufficiency in postoperative 1 year was statistically significant,comparing with before treatment（t=16.56,12.10,11.76,P〈0.05）.Conclusion Combination of autologous pericardium enlargement of anterior tricuspid leaflet and artificial valve annuloplasty shows considerable clinical effect in the treatment of severe tricuspid insufficiency.It is worthy of promotion.

关 键 词：重度三尖瓣关闭不全 自体心包扩大三尖瓣前叶 人工瓣环成形 

分 类 号：R654.2[医药卫生—外科学]