保留瓣下结构对二尖瓣狭窄为主型患者瓣膜置换术后早期心功能变化的影响  

Effect of subvalvular apparatus preservation on early postoperative cardiac function in patients with dominantly mitral stenosis undergoing valve replacement

作　　者：张万青 梁克 戚春梅 曹勇[3] 陈波[3] 刘培兰 陈如红 程可洛 陈雪松 黄伟 任冉 ZHANG Wan-qing;LIANG Ke;QI Chun-mei;CAO Yong;CHEN Bo;LIU Pei-lan;CHEN Ru-hong;CHENG Ke-luo;CHEN Xue-song;HUANG Wei(Department of Cardiothoracic Surgery,Affiliated Hospital of Guangdong Medical University,Zhanjiang 524001,China;Department of Pharmacy,Second Affiliated Hospital of Guangdong Medical University,Zhanjiang 524003,China;Department of Cardiac Surgery,Gaozhou People’s Hospital,Gaozhou 525200,China;Outpatient Department,Guangdong Medical University,Dongguang 523808,China;Department of Ultrasonography,Affiliated Hospital of Guangdong Medical University,Zhanjiang 524001,China)

机构地区：[1]广东医科大学附属医院胸心外科,广东湛江524001 [2]广东医科大学第二附属医院药剂科,广东湛江245003 [3]广东省高州市人民医院心脏外科,广东高州255200 [4]广东医科大学门诊部,广东东莞235808 [5]广东医科大学附属医院超声科,广东湛江245001

出　　处：《广东医科大学学报》2018年第5期516-519,共4页Journal of Guangdong Medical University

基　　金：广东省科技厅科技计划项目(No.2012B061700 039)

摘　　要：目的了解保留瓣下结构对二尖瓣狭窄为主型患者瓣膜置换术后早期心功能的影响。方法 121例二尖瓣狭窄为主型患者作瓣膜置换术,其中保留全瓣瓣下结构5例(保留全瓣组),保留后瓣瓣下结构58例(保留后瓣组),二尖瓣及瓣下腱索全切58例(全切组)。术后1～6个月行心脏彩色超声多普勒检查。结果各组未见左心室流入道及流出道梗阻、瓣膜功能障碍,左房舒张期前后径、左室射血分数差异无统计学意义(P>0.05);保留全瓣组左室舒张期横径、左室短轴缩短率大于保留后瓣组及全切组(P<0.05)。结论保留瓣下结构对术后早期左室射血分数无明显影响,但全瓣保留者左室短轴缩短率明显提高。Objective To study the impact of subvalvular apparatus(SVA)preservation on early postoperative cardiac function in patients with dominantly mitral stenosis(MS)undergoing valve replacement.Methods A total of 121 patients with dominantly MS underwent valve replacement with total SVA preservation(n=5),posterior SVA preservation(n=58)and total SVA excision(n=58).Echocardiography was performed 1-6 months postoperatively.Results There were no left ventricular inflow and outflow obstruction and valve dysfunction in all cases.Left atrial diastolic diameter(LADD)and left ventricular ejection fraction(LVEF)were insignificant among 3 groups(P>0.05),while left ventricular diastolic diameter(LVDD)and left ventricular fractional shortening(LVFS)were higher in total SVA preservation group than in posterior SVA preservation and total SVA excision groups(P<0.05).Conclusion SVA preservation has no effect on LVEF,but total SVA preservation can improve LVFS.

关 键 词：心脏瓣膜病 二尖瓣狭窄 瓣膜置换术 

分 类 号：R654.2[医药卫生—外科学]