超声心动图在评估二尖瓣机械瓣置换术后短期疗效的价值  

Value of echocardiography in evaluating short-term outcome after mitral valve replacement

作　　者：陈妹花 黄旴宁 张秋元 严春苗 王乐华[1] CHEN Meihua;HUANG Xuning;ZHANG Qiuyuan;YAN Chunmiao;WANG Lehua(Department of Ultrasonography, The Second Affiliated Hospital of Hainan Medical University, Haikou 570311, P.R.China)

机构地区：[1]海南医学院第二附属医院超声医学科,海南海口570311

出　　处：《医学影像学杂志》2020年第7期1166-1168,共3页Journal of Medical Imaging

基　　金：海南省高等学校科学研究资助项目(编号:Hnky2017-29)。

摘　　要：目的探讨超声心动图评价二尖瓣机械瓣置换术后短期心脏结构及血流动力学改变的价值。方法回顾性分析61例因风湿性心脏病(RHD)二尖瓣狭窄在我院接受二尖瓣机械瓣置换术患者的超声心动图检查资料。将术前、术后1周、3个月、6个月及1年5个时间段的超声心动图主要指标进行统计学分析。结果与术前比较,术后1周、3个月、6个月及1年左心房前后径(LAD)、二尖瓣峰值流速(Vp)及平均跨瓣压差(MPG)均减小及下降,有显著统计学意义(P<0.01);术后各时间段左心室射血分数(LVEF)无明显变化(P>0.05);术后Vp及MPG随着时间推移逐渐上升,其中与术后1周比较,术后3个月增高无明显统计学差异(P>0.05),术后6个月及术后1年,Vp及MPG增高有统计学差异(P<0.05);与术后3个月比较,术后1年Vp及MPG亦明显增高(P<0.05)。结论二尖瓣机械瓣置换术后血流动力学明显改善,超声心动图能准确评价其变化。Objective To evaluate the value of echocardiography in the assessment of short-term cardiac structure and hemodynamic changes after mitral valve Replacement(MVR).Methods We retrospectively analyzed echocardiography data of 61 patients with RHD mitral stenosis who underwent prosthetic MVR and finished echocardiography examination at preoperation,and 1 week,3 months,6 months,1 year after surgery in our Hospital.Results Compared with the preoperative dimensions,left atrium dimension(LAD),Mitral valve peak velocity(Vp)and mitral valve mean transprosthetic pressure gradients(MPG)were decreased(P<0.01),while no statistical difference was found in left ventricular ejection fraction(LVEF)between preoperative and postoperative value(P>0.05).During short-term follow-up,Vp and MPG gradually increased with time after surgery,the Vp and MPG were higher than 1 week after MVP,compared with 1 week after operation,there was no significant difference in the increase of 3 months after operation(P>0.05),while Vp and MPG increased obviously in 6 months and 1 year after operation(P<0.05);Compared with 3 months after operation,Vp and MPG were also significantly increased in 1 year after surgery(P<0.05).Conclusion Hemodynamics are significantly improved after MVP,and echocardiography can accurately evaluate its changes.

关 键 词：风湿性心脏病 二尖瓣狭窄 二尖瓣置换术 超声心动图 

分 类 号：R542.5[医药卫生—心血管疾病] R445.1[医药卫生—内科学]