三尖瓣成形环连续缝合与间断缝合植入的对比研究  

Comparison of efficacy between continuous suture and interrupted suture for implantation of tricuspid valvuloplasty ring

作　　者：苏超 倪一鸣[1] 郑骏楠 SU Chao;NI Yiming;ZHENG Junnan(Department of Cardiovascular Surgery,the First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China)

机构地区：[1]浙江大学医学院附属第一医院心脏大血管外科,杭州310003

出　　处：《浙江医学》2022年第7期707-712,I0005,共7页Zhejiang Medical Journal

基　　金：浙江省基础公益研究计划项目(LQ20H020004)。

摘　　要：目的对比分析连续缝合与间断缝合方法植入三尖瓣成形环治疗三尖瓣关闭不全的临床效果。方法回顾性分析2009年10月至2021年1月于浙江大学医学院附属第一医院心脏大血管外科植入三尖瓣成形环行三尖瓣成形术的586例三尖瓣关闭不全患者的临床资料。依据术中缝合方式的不同,分为连续缝合组208例和间断缝合组378例。观察并比较两组患者术中情况、术后情况、术后随访期间情况,并分别比较植入软环(313例)、硬环(273例)的两组患者围术期情况及术后随访期间情况。结果两组患者术中阻断时间、转流时间、使用的三尖瓣成形环型号比较差异均无统计学意义(均P>0.05),术后ICU住院时间、总住院时间、术后并发症、围术期死亡率、术后左心室射血分数、手术失败率比较差异均无统计学意义(均P>0.05)。但连续缝合组患者术后三尖瓣反流程度轻度及以下占比高于间断缝合组(P<0.05)。两组患者术后随访期间心功能等级、死亡率比较差异均无统计学意义(均P>0.05),连续缝合组患者随访期间三尖瓣反流程度轻度及以下的占比高于间断缝合组(P<0.05)。除植入软环的连续缝合组患者术中转流时间短于间断缝合组(P<0.05)外,植入软环、硬环的两组患者围术期情况及术后随访期间情况比较差异均无统计学意义(均P>0.05)。结论连续缝合与间断缝合植入三尖瓣成形环治疗三尖瓣关闭不全患者效果相当。Objective To compare the efficacy of continuous suture and intermittent suture in implantation of tricuspid valvuloplasty ring for patients with tricuspid regurgitation.Methods The clinical data of 586 patients with tricuspid regurgitation who underwent tricuspid valvuloplasty from October 2009 to January 2021 at Department of Cardiovascular Surgery,the First Affiliated Hospital,Zhejiang University School of Medicine were analyzed retrospectively.The continuous suture technique was used in 208 cases(continuous group),and the interrupted suture technique in 378 cases(interrupted group).The baseline information,intraoperative condition,postoperative complications and postoperative follow-up information of the two groups were observed and compared.The above indicators were also compared between patients implanted with flexible rings(313 cases)and patients implanted with rigid rings(273 cases).Results There were no significant differences in cross-clamp time,cardiopulmonary bypass time and the type of tricuspid valvuloplasty ring between the continuous group and interrupted group(all P>0.05).There were no significant differences in the length of postoperative ICU stay,total length of hospital stay,postoperative complications,perioperative mortality,postoperative left ventricular EF and operation failure rate between the two groups(all P>0.05).However,the proportion of patients with mild or trace postoperative tricuspid regurgitation in the continuous suture group was higher than that in the interrupted suture group(P<0.05).There was no significant difference in cardiac function grade and mortality during postoperative follow-up between two groups(all P>0.05).The intraoperative bypass time in patents implanted with flexible rings was short than that in patients with rigid rings(P<0.05).Otherwise there were no significant differences in perioperative and postoperative follow-up conditions between the two groups(all P>0.05).Conclusion The efficacy of continuous suture and intermittent suture is comparable in implantatio

关 键 词：三尖瓣关闭不全 心脏瓣膜成形 缝合技术 

分 类 号：R654.2[医药卫生—外科学]