合并左心功能不全患者行自体心包软环三尖瓣环成形术的近期和远期疗效  

Short term and long-term outcomes of tricuspid annuloplasty with autologous pericardial soft ring in patients with left ventricular dysfunction

作　　者：蒋伟[1] 韦科全 李思聪 钟永泷[1] 贺榜福[1] 林辉[1] 龙小毛[1] JIANG Wei;WEI Kequan;LI Sicong;ZHONG Yonglong;HE Bangfu;LIN Hui;LONG Xiaomao(Department of Cardiothoracic Vascular Surgery,People′s Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China)

机构地区：[1]广西壮族自治区人民医院心胸血管外科,南宁530021

出　　处：《实用医学杂志》2022年第3期350-353,共4页The Journal of Practical Medicine

基　　金：广西自然科学基金资助项目(编号:2016GXNSFAA380079);广西卫生厅资助项目(编号:Z2015366)。

摘　　要：目的分析合并左心功能不全患者行自体心包软环三尖瓣环成形术的近期和远期疗效。方法选择2014年1月至2015年1月于我院收治的三尖瓣反流合并左心功能不全患者80例,随机分为对照组及观察组,分别给予De Vega三尖瓣成形术及自体心包软环三尖瓣环成形术治疗。收集并比较两组患者一般资料。检查各组患者心功能变化。随访至术后5年,比较各组患者术后发生中度以上三尖瓣反流人数、5年再次入院率、5年生存率及术后并发症。结果术后观察组患者RVD、LAD水平明显低于对照组,LVED、CO、LVEDD、LVEF水平明显高于对照组(P<0.05)。重度反流患者中,观察组患者TR水平明显低于对照组(P<0.05)。术后5年中,观察组发生中度以上三尖瓣反流人数、5年再次入院率均明显低于对照组,5年生存率明显高于对照组(P<0.05)。结论自体心包软环三尖瓣环成形术治疗三尖瓣反流合并左心功能不全技术简单、安全有效,早期可快速恢复患者心功能,随访期间效果明显优于De Vega三尖瓣成形术,可明显改善患者生活质量,延长患者生命周期。Objective To analyze the short-term and long-term effects of tricuspid annuloplasty with autologous pericardial soft ring on left ventricular dysfunction.Methods Eighty patients with tricuspid regurgitation complicated with left ventricular dysfunction treated in our hospital from January 2014 to January 2015 were randomly divided into control group and observation group.The former was treated with de Vega tricuspid valvuloplasty and the latter with autologous pericardial soft ring tricuspid valvuloplasty.The general data of the two groups were collected and compared.The changes of cardiac function in both groups were examined.The two groups were compared in terms of the number of patients with moderate or above tricuspid regurgitation,5-year readmission rate,5-year survival rate and postoperative complications.Results The levels of RVD and LAD in the observation group were significantly lower than those in the control group,and the levels of LVED,Co,LVEDd and LVEF in the observation group were significantly higher than those in the control group(P<0.05).The level of TRAs in the patients with severe reflux in the observation group was significantly lower than that in those with severe reflux in the control group(P<0.05).In 5 years after operation,the number of patients with moderate tricuspid regurgitation and 5-year readmission rate in the observation group were significantly lower than those in the control group,and the 5-year survival rate was significantly higher than that in the control group(P<0.05).Conclusion Autologous pericardial soft ring tricuspid annuloplasty is simple,safe and effective in the treatment of tricuspid regurgitation combined with left ventricular insufficiency,and it can quickly restore the cardiac function of patients in the early stage,and its effect during the follow-up period is significantly better than De Vega tricuspid annuloplasty.It can significantly improve their quality of life and prolong their life.

关 键 词：左心功能不全 自体心包软环三尖瓣环成形术 疗效 

分 类 号：R542.53[医药卫生—心血管疾病] R654.2[医药卫生—内科学]