单纯超声与X线透视引导下二尖瓣球囊扩张术的早期临床结果对比研究  

Comparison on Early Clinical Results of Percutaneous Balloon Mitral Valvuloplasty Under Guidance of Echocardiography or X-ray Fluoroscopy

作　　者：李慕子 刘垚 徐楠[1] 王剑鹏[1] 江勇[1] 潘湘斌[1] 逄坤静[1] LI Muzi;LIU Yao;XU Nan;WANG Jianpeng;JIANG Yong;PAN Xiangbin;PANG Kunjing(Ultrasound Imaging Center,National Center for Cardiovascular Diseases and Fuwai Hospital,CAMS and PUMC,Beijing(100037),China)

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外医院超声影像中心

出　　处：《中国循环杂志》2019年第9期882-886,共5页Chinese Circulation Journal

摘　　要：目的:对比分析单纯超声心动图引导下经皮二尖瓣球囊扩张术(PBMV)与传统X线透视引导下PBMV的有效性和安全性。方法:回顾性选取2016年11月至2018年3月期间阜外医院接受单纯超声引导下行PBMV的风湿性二尖瓣狭窄(MS)患者21例(单纯超声引导组);另外选择同期在X线透视引导下行PBMV的77例患者作为对照(X线引导组)。比较两组患者一般情况、手术效果、术后并发症等情况。结果:两组的手术成功率、手术时间、术后二尖瓣瓣口面积、二尖瓣平均跨瓣压差、住院天数及总费用方面差异均无统计学意义(P均>0.05)。单纯超声引导组术后新发二尖瓣反流的患者比例比X线引导组少[3例(14.3%)vs 29例(37.7%),P<0.05],前者在透视时间[0 min vs(25.01±4.81)min,P<0.05]方面更优。结论:单纯超声引导下PBMV与传统X线透视引导下PBMV同样具有微创、有效的优点,治疗效果一致,但前者克服了辐射损伤,提高了手术安全性,可减少并发症。Objectives:To compare the efficacy and safety of percutaneous balloon mitral valvuloplasty(PBMV)under the guidance of echocardiography or X-ray fluoroscopy.Methods:Clinical data of 98 patients with mitral valve stenosis,who underwent PBMV in Fuwai Hospital from November 2016 to March 2018,were analyzed retrospectively.The patients were divided into two groups:PBMV guided with echocardiography(n=21)and guided with X-ray fluoroscopy(n=77).The baseline characteristics,procedure results and complications were recorded and compared.Results:There were no significant difference in operation success rate,procedural time,mitral valve area and mitral transvalvular mean pressure gradient after operation,hospital stay and total cost between the two groups(all P>0.05).However,number of the new-onset mitral regurgitation was significantly lower(3[14.3%]vs 29[37.7%],P<0.05)in the echocardiography guidance group than in the fluoroscopy group(P<0.05).X-ray fluoroscopy time was 0 min in the echocardiography guidance group versus(25.01±4.81)min in the fluoroscopy group(P<0.05).Conclusions:PBMV can be successfully performed under the guidance of echocardiography with outcomes similar to those achieved with X-ray fluoroscopy guidance.Patients in the PBMV under the guidance of echocardiography group are also benefited from the no radiation exposure and lower complication rate.

关 键 词：超声心动图描记术 二尖瓣狭窄 球囊扩张术 X线 

分 类 号：R54[医药卫生—心血管疾病]