复合二尖瓣成形技术在风湿性二尖瓣复合体病变中的应用  

The role of composite mitral valvuloplasty inrheumatic mitral valve complex lesions

作　　者：浮志坤[1] 杨慧娟[1] 杨恒[1] 董炎 杜鹏 郭琳[2] 于慧娟[3] 张向立[1] FU Zhikun;YANG Huijuan;YANG Heng;DONG Yan;DU Peng;GUO Lin;YU Huijuan;ZHANG Xiangli(Department of Cardiac Surgery,Zhengzhou Seventh People′s Hospital,Zhengzhou 450012,China)

机构地区：[1]郑州市第七人民医院心脏外科,郑州450012 [2]郑州市第七人民医院重症医学科,郑州450012 [3]郑州市第七人民医院超声科,郑州450012

出　　处：《实用医学杂志》2020年第14期1924-1928,共5页The Journal of Practical Medicine

基　　金：河南省医学科技攻关计划联合共建项目(编号:2018020854)。

摘　　要：目的探讨复合二尖瓣成形技术在风湿性二尖瓣复合体病变中的临床疗效。方法选取2016年1月至2017年12月在郑州市第七人民医院心脏外科因风湿性二尖瓣复合体病变治疗的患者152例为研究对象。其中63例患者应用复合二尖瓣成形技术行二尖瓣成形术(观察组),89例患者行二尖瓣置换术(对照组)。其中观察组男23例,女40例,平均年龄(43.52±7.81)岁;对照组男48例,女41例,平均年龄(45.27±6.34)岁。收集两组患者的基线资料、术前超声结果、围术期资料、术后出院时资料及随访资料(3、6、12个月),分析复合二尖瓣成形技术的临床效果。结果观察组的主动脉阻断时间、体外循环时间较对照组延长,差异有统计学意义(P <0.05)。两组对比围术期引流量、住院时间差异无统计学意义(P>0.05)。观察组术后呼吸机辅助时间、ICU滞留时间、并发症发生率、病死率较对照组低,差异有统计学意义(P <0.05)。观察组术后3个月左房内径回缩、左室舒末内径回缩、肺动脉收缩压下降、左室射血分数改善,较对照组差异有统计学意义(P <0.05)。结论复合二尖瓣成形技术能够显著提高风湿性二尖瓣复合体病变的临床救治效果,能够优化和改善患者术后心脏的重构及恢复,临床效果满意。Objective To investigate the clinical efficacy of composite mitral valve plasty in rheumaticmitral valve complex disease.MethodsFrom January 2016 to December 2017,152 patients who were treated forrheumatic mitral valve complex disease at the Department of Cardiac Surgery of Zhengzhou Seventh People′s Hospitalwere selected as the research subjects. Among them,63 patients underwent mitral valve angioplasty using themitral valve angioplasty technique(experimental group)and 89 patients underwent mitral valve replacement(controlgroup). There were 23 males and 40 females in the test group,aged(43.52 ± 7.81)years;48 males and 41 femalesin the control group,aged(45.27 ± 6.34)years. Baseline data,preoperative ultrasound results,perioperativedata,postoperative discharge,and follow-up data(3 months,6 months,and 12 months)were collected fromtwo groups of patients,and the clinical effects of the combined mitral valve angioplasty technique were analyzed.ResultsThe aortic occlusion time and cardiopulmonary bypass time in the test group were longer than those in thecontrol group,with statistical differences(P < 0.05). There was no significant difference in perioperative drainageand hospital stay between the two groups(P > 0.05). The postoperative ventilator assist time,ICU retention time,complication rate,and mortality were significantly lower in the experimental group than that in the control group(P < 0.05). In the test group,the left atrial inner diameter retraction,left ventricular end diastolic inner diameterretraction,pulmonary artery systolic blood pressure reduction,and left ventricular ejection fraction improvement at3 months after operation were significantly different from that in the control group(P < 0.05).ConclusionCom-posite mitral valve angioplasty can significantly improve the clinical treatment effect of rheumatic mitral valve com-plex lesions. It can optimize and improve the patient′s postoperative cardiac reconstruction and recovery with satis-factory clinical results.

关 键 词：复合二尖瓣成形术 风湿 二尖瓣复合体 

分 类 号：R654.2[医药卫生—外科学]