瓣膜置换和成形术治疗二尖瓣置换术后三尖瓣关闭不全患者的疗效比较  

Comparison of valve replacement and plasty in the treatment effect of patients with three cuspid insufficiency after mitral valve replacement

作　　者：于洪涛[1] 王湘[1] 杨晓涵[1] 陈文斌[2] 张锐[1] 李刚[1] 王尧 杨建安[1] YU Hong-tao;WANG Xiang;YANG Xiao-han;CHEN Wen-bin;ZHANG Rui;LI Gang;WANG Rao;YANG Jian-an(Department of Cardiovascular Surgery,Sun Yat-Sen Cardiovascular Hospital,Shenzhen,Guangdong 518057,China;Department of Ultrasound,Sun Yat-Sen Cardiovascular Hospital,Shenzhen,Guangdong 518057,China)

机构地区：[1]深圳市孙逸仙心血管医院心血管外科,广东深圳518057 [2]深圳市孙逸仙心血管医院超声科,广东深圳518057

出　　处：《岭南心血管病杂志》2019年第3期287-289,316,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的比较瓣膜置换和成形术治疗二尖瓣置换术后三尖瓣关闭不全的效果。方法抽调2015年10月至2017年7月在深圳市孙逸仙心血管医院诊治的20例二尖瓣置换术后三尖瓣关闭不全患者作为研究对象,按照治疗的不同分为两组,各组10例。其中对照组采用瓣膜置换术,研究组实施三尖瓣成形术,比较两组患者手术前后超声心动图的各项指标、心脏各项指标、心功能分级情况及治疗效果。结果术前两组患者超声心动图的各项指标、心脏各项指标、心功能分级情况比较,差异无统计学意义(P>0.05)。术后研究组各项指标包括胸腔引流液[(1 004.12±490.63)mL vs.(1 198.65±403.56)mL,t=0.968,P=0.346]及体外循环时间[(92.54±32.54)min vs.(135.10±25.47)min,t=3.257,P=0.004]等均显著优于对照组,差异有统计学意义。结论通过对二尖瓣置换术后三尖瓣关闭不全的患者采取三尖瓣成形术治疗,治疗后各项心脏功能得到改善,效果显著,值得应用。Objectives To compare the effects of mitral valve replacement and valvuloplasty in the treatment of patients with three cuspid insufficiency after mitral valve replacement. Methods Twenty patients with three cuspid insufficiency who underwent mitral valve replacement from October 2015 to July 2017 in Sun Yat-Sen Cardiovascular Hospital were selected and divided into control group and study group according to the treatment,10 patients in each group. Control group was treated with valve replacement and study group was treated with tricuspid valvuloplasty. Echocardiographic indexes, cardiac indexes, cardiac function classification and treatment effect were compared between the two groups before and after operation. Results Before operation,there were no significant differences in echocardiographic indexes,cardiac indexes and cardiac function classification between the two groups(P>0.05). After operation,study group was significantly better than control group in all aspects,including thoracic drainage fluid [(1 004.12±490.63)mL vs.(1 198.65±403.56)mL,t=0.968,P=0.346]and cardiopulmonary bypass[(92.54± 32.54)min vs.(135.10±25.47)min,t=3.257,P=0.004]. Conclusions Three cuspid valvuloplasty performing in patents with three cuspid insufficiency after mitral valve replacement can improve cardiac function and get remarkable treatment effect,it is worth of clinical application.

关 键 词：瓣膜置换 成形术 二尖瓣置换术 三尖瓣关闭不全 

分 类 号：R542.5[医药卫生—心血管疾病]