硬质三维成形环治疗中度功能性三尖瓣反流的疗效分析  

Clinical effect of rigid three-dimensional annuloplasty ring in surgical treatment of moderate functional tricuspid regurgitation

作　　者：赵亮[1] 彭晓波 陈劲进 翟建宾[1] 范子盼 肖颖彬 ZHAO Liang;PENG Xiao-bo;CHEN Jin-jin;ZHAI Jian-bin;FAN Zi-pan;XIAO Ying-bin(Department of Cardiothoracic Surgery,Bethune International Peace Hospital,Shijiazhuang Hebei 050082,China;Department of Cardiovascular Surgery,Second Hospital Affiliated to AMU,Chongqing,400037,China)

机构地区：[1]白求恩国际和平医院心胸外科,河北石家庄050082 [2]陆军军医大学第二附属医院心外科,重庆400037

出　　处：《局解手术学杂志》2018年第9期642-645,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：河北省医学科学研究重点课题(20150006

摘　　要：目的探讨分析硬质三维成形环在治疗功能性三尖瓣反流(FTR)中的临床疗效。方法 2015年9月至2016年6月在陆军军医大学第二附属医院心外科术前经超声心动图检查确诊左心瓣膜疾病合并中度FTR患者42例,在接受左心瓣膜心脏手术同时采用硬质三维成形环治疗FTR。对比分析手术前后三尖瓣反流面积,右心室大小和肺动脉压力变化,评估三尖瓣成形手术的临床疗效。结果 42例患者均无手术死亡;术前三尖瓣反流均为中度,反流面积(6. 01±0. 98) cm^2,术后三尖瓣无反流患者39例(92. 86%),轻度反流患者3例(7. 14%),无中、重度三尖瓣反流患者。三尖瓣成形术后右心室均明显缩小(P <0. 05),肺动脉压力明显降低(P <0. 05)。结论对于合并中度FTR的左心系统瓣膜疾病患者,采用硬质三维成形环治疗取得了满意的手术效果,采取积极的手术治疗策略三尖瓣成形术后的疗效可能更为满意。Objective To analyze the clinical effect of rigid three-dimensional annuloplasty ring in the surgical treatment of functional tricuspid regurgitation（FTR）. Methods From September 2015 to June 2016,42 patients of left-sided valve disease with moderate FTR diagnosed by echocardiography before FTR in cardiovascular surgery department of second hospital affiliated to AMU were treated by rigid three-dimensional annuloplasty ring during left-sided valve operation.The tricuspid regurgitation area,right ventricular size and changes in pulmonary artery pressure before and after surgery were compared.The clinical effect of tricuspid annuloplasty was studied and analyzed. Results There was no operative death in 42 patients.The grades of tricuspid regurgitation were all moderate before operation and the mean regurgitation area was （6.01±0.98）cm 2.There were 39 cases （92.86%） with no tricuspid regurgitation and 3 cases（7.14%） with mild regurgitation after operation.There was no moderate or severe tricuspid regurgitation.After tricuspid annuloplasty,the diameter of right ventricle was significantly reduced（ P 〈0.05） and the pulmonary artery pressure was significantly decreased（ P 〈0.05）. Conclusion For patients of left heart valvular disease with moderate FTR,a satisfactory surgical effect was achieved by using rigid three-dimensional annuloplasty ring.The more actively the surgical tricuspid annuloplasty is,the curative effect may be more satisfactory.

关 键 词：功能性三尖瓣反流 硬质三维三尖瓣成形环 体外循环 

分 类 号：R654.2[医药卫生—外科学]