二尖瓣成型环成型术治疗左心室扩大引起二尖瓣反流的效果  

Effect of mitral annuloplasty in the treatment of mitral regurgitation caused by left ventricle enlargement

作　　者：李绪东 胡宁东 刘秋华 梁计焕 万海霞 夏旭 LI Xu-dong;HU Ning-dong;LIU Qiu-hua;LIANG Ji-huan;WAN Hai-xia;XIA Xu(Department of Cardiothoracic Surgery,Qingyuan People′s Hospital,Guangdong Province,Qingyuan511500,China)

机构地区：[1]广东省清远市人民医院胸心外科,广东清远511500

出　　处：《中国当代医药》2020年第28期51-54,共4页China Modern Medicine

摘　　要：目的探讨二尖瓣成型环成型术治疗左心室扩大引起二尖瓣反流的效果。方法选取2013年1月~2019年6月在我院心胸外科治疗的40例左心室扩大引起的二尖瓣反流患者作为研究对象,采用随机数字表法将其分为两组。对照组20例使用二尖瓣置换术,观察组20例使用二尖瓣成型环成型术。比较两组患者的手术疗效、各项手术指标及手术前后心功能[左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左室射血分数(LVEF)、左房内径(LAD)、心功能分级]。结果两组患者的手术成功率、再次手术率、并发症发生率、术中及术后死亡率比较,差异无统计学意义(P>0.05)。观察组患者的阻断时间、体外循环时间均长于对照组,术后输血率低于对照组,差异有统计学意义(P<0.05);两组患者的术后1 d引流量、住院时间比较,差异无统计学意义(P>0.05)。观察组患者术前、术后6个月的LVEDD、LVESD、LVEF、LAD、心功能分级与对照组比较,差异无统计学意义(P>0.05);两组患者术后6个月的LVEDD、LVESD、LAD均小于术前,心功能分级低于术前,LVEF高于术前,差异有统计学意义(P<0.05)。结论二尖瓣成型环成型术治疗左心室扩大引起二尖瓣反流的效果显著,手术成功率高,并发症发生率低,能有效改善心功能,纠正瓣膜反流,且避免了置换术所需的长期抗凝治疗,具有积极的临床意义。Objective To explore the effect of mitral annuloplasty in the treatment of mitral regurgitation caused by left ventricle enlargement.Methods Forty patients with mitral regurgitation caused by left ventricle enlargement treated in cardiothoracic surgery department of our hospital from January 2013 to June 2019 were selected as the research objects and divided into two groups by the random number method.Mitral valve replacement was performed in patients in the control group(n=20),and mitral annuloplasty was performed in patients in the observation group(n=20).The operation curative effect,operation indexes and heart function(left ventricular end-diastolic diameter[LVEDD],left ventricular end-systolic diameter[LVESD],left ventricular ejection fraction[LVEF],the left atrial diameter[LAD]and cardiac function grading)before and after operation were compared between the two groups.Results There were no statistically significant differences in the operative successful rate,the reoperation rate,the incidence rate of complications and the intraoperative or postoperative mortality between the two groups(P>0.05).The blocking time and the cardiopulmonary bypass time in the observation group were longer than those in the control group,with statistically significant differences(P<0.05).There were no statistically significant differences in the drainage volume 1 day after the operation and the length of hospital stay between the two groups(P>0.05).There were no statistically significant differences in the LVEDD,LVESD,LVEF,LAD,cardiac function grading before operation and 6 months after the operation between the observation group and the control group(P>0.05).In the two groups,LVEDD,LVESD,LAD at 6 months after the operation were smaller than those before operation,the cardiac function grading at 6 months after the operation was lower than that before operation,and LVEF at 6 months after the operation was higher than that before operation,with statistically significant differences(P<0.05).Conclusion The effect of mitral annuloplas

关 键 词：左心室扩大 二尖瓣反流 二尖瓣成型环成型术 效果 

分 类 号：R541[医药卫生—心血管疾病]