风湿性二尖瓣狭窄合并小左心室40例外科手术治疗的临床分析  

Clinical analysis of surgical treatment of 40 cases with rheumatic mitral stenosis complicated with small left ventricle

作　　者：叶华安[1] 封加涛[1] 彭峰[1] 苏艳玲[1] 简劲峰[1] 林家旺[1] YE Hua-an;FENG Jia-tao;PENG Feng;SU Yan-ling;JIAN Jing-feng;LIN Jia-wang(Department of Cardiac Surgery,The First People′s Hospital of Foshan City,Foshan,Guangdong 528000,China)

机构地区：[1]佛山市第一人民医院心血管外科,广东佛山528000

出　　处：《岭南心血管病杂志》2017年第6期708-711,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的总结风湿性二尖瓣狭窄合并小左心室患者的外科治疗经验。方法回顾性分析佛山市第一人民医院2008年8月至2016年7月收治的40例接受外科手术治疗的风湿性二尖瓣狭窄合并小左心室患者的临床资料。结果术后心功能Ⅰ级、Ⅱ级患者比例明显上升,心功能Ⅲ级、Ⅳ级患者比例显著降低,与术前比较,差异有统计学意义(P<0.05)。术后患者左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、左心室舒张末期容积指数(LVEDVI)上升,左心房内径(LAD)、术前肺动脉收缩压(SPAP)、中心静脉压(CVP)均降低,与术前比较,差异有统计学意义(P<0.05)。患者术后并发症发生率为17.50%,病死率为5.00%。结论为提高风湿性二尖瓣狭窄合并小左心室外科手术效果,减少术后并发症发生率,必须重视围术期处理,且术中必须重视患者的心肌保护。Objectives To summarize the experience of surgical treatment of patients with rheumatic mitral stenosis complicated with small left ventricle.Methods Clinical data of40patients with rheumatic mitral stenosis complicated with small left ventricle treated in The First People′s Hospital of Foshan City from August2008to July2016were retro?spectively analyzed.Results Percentages of patients with gradeⅠand gradeⅡcardiac function significantly increased(P<0.05),while percentages of patients with gradeⅢandⅣcardiac function significantly decreased(P<0.05).After surgery,left ventricular end diastolic dimension(LVEDD),left ventricular ejection fraction(LVEF)and left ventricu?lar end-diastolic volume index(LVEDVI)increased,while left atrial diameter(LAD),systolic pulmonary artery pressure(SPAP)and central venous pressure(CVP)decreased.Compared with those before surgery,there were signif?icant differences(P<0.05).Incidence of complications after surgery and mortality were17.50%and5.00%respective?ly.Conclusions To improve the effect of surgical treatment of rheumatic mitral stenosis with small left ventricle and re?duce the incidence of complications after surgery,attention should be paid to perioperative treatment and myocardial protection of patients.

关 键 词：风湿性心脏病 二尖瓣狭窄 小左心室 手术 

分 类 号：R541.2[医药卫生—心血管疾病]