改良人工腱索技术应用于二尖瓣成形术的近期效果评价  

Evaluation of the short-term effect of modified artificial tendon technique in mitral valvuloplasty

作　　者：王圣 任培军 陈现杰 陆国庆 朱喜亮 徐高俊 程兆云 赵亮 杨雷一 WANG Sheng;REN Peijun;CHEN Xianjie;LU Guoqing;ZHU Xiliang;XU Gaojun;CHENG Zhaoyun;ZHAO Liang;YANG Leiyi(Fuwai Central China Cardiovascular Hospital,Heart Center of Henan Provincial People's Hospitals People's Hospital of Zhengzhou University,Zhengzhou,451464,China)

机构地区：[1]阜外华中心血管病医院,河南省人民医院心脏中心,郑州大学人民医院,郑州451464

出　　处：《临床心血管病杂志》2021年第8期728-731,共4页Journal of Clinical Cardiology

摘　　要：目的:探讨改良人工腱索(Loop)技术应用于二尖瓣成形术的近期效果。方法:选择2019年2月—2020年10月在本院治疗的二尖瓣关闭不全患者31例,所有患者均使用Loop技术行二尖瓣成形术,观察患者术中情况与术后心功能等。结果:31例患者使用Loop技术二尖瓣成形术均成功,手术中未发生二尖瓣置换或再次二尖瓣成形,平均植入Loop数为(2.2±0.6)个;手术中体外循环时间为(87.4±8.8)min,术中主动脉阻断时间为(60.7±7.9)min。围手术期无死亡病例;术后早期新发心房颤动2例,低心排综合征1例,急性肾功能不全1例。随访1~18个月,平均(10.7±2.3)个月,无死亡病例。与手术前相比,所有患者术后1周、1个月及半年的心功能、左室舒张末期内径(LVEDD)、二尖瓣口面积(MVA)、二尖瓣跨瓣压差(MVG)、每分输出量(CO)改善显著,差异有统计学意义(P<0.05)。手术中TEE结果显示,二尖瓣无反流或微量反流30例,轻度反流1例;术后1周无反流或微量反流30例,轻度反流1例;术后1个月无反流或微量反流29例,轻度反流2例;术后半年无反流或微量反流28例,轻度反流3例。结论:Loop技术应用于二尖瓣成形术对二尖瓣关闭不全的治疗效果较好,操作简单易行,重复性好,便于学习掌握,容易推广,并且随访观察近期治疗效果较好。Objective:To explore the short-term effect of modified artificial tendon(Loop)technique in mitral valvuloplasty.Methods:Thirty-one patients with mitral regurgitation who were treated in our hospital from February 2019 to October 2020 were selected.All patients underwent Loop technique mitral valvuloplasty.The intraoperative condition and postoperative cardiac function were observed.Results:All patients treated with Loop technique mitral valvuloplasty were successful without mitral valve replacement or mitral valve reconstruction.The mean number Loop was(2.2±0.6),the mean time of cardiopulmonary bypass was(87.4±8.8)min,and the mean time of aortic clamp was(60.7±7.9)min.There was no death in the perioperative period.The early postoperative complications included new-onset atrial fibrillation in two cases,low cardiac output syndrome in one case,and acute renal insufficiency in one case.All patients were followed up for 1-18 months,with an average of(10.7±2.3)months,and there was no death.Compared with the preoperation,the cardiac function,left ventricular end-diastolic diameter(LVEDD),mitral orifice area(MVA),mitral valve gradient(MVG),and output per minute(CO)of all patients improved significantly after one week,one month and half a year(all P<0.05).TEE in the operation showed that there were 30 cases with no or slight mitral regurgitation and one case with mild mitral regurgitation;One week after the operation,30 cases had no or slight regurgitation and one case had mild regurgitation;Half a year after the operation,28 cases had no or slight regurgitation and three cases had mild regurgitation.Conclusion:The application of Loop technique in mitral valvuloplasty for the treatment of mitral regurgitation has a good effect,simple operation,good repeatability,is easy to learn and promote,and has good short-term treatment effect.

关 键 词：改良人工腱索技术 二尖瓣成形术 近期效果 

分 类 号：R542.5[医药卫生—心血管疾病]