冠状动脉旁路移植术中同期二尖瓣手术治疗中重度缺血性二尖瓣关闭不全的效果  

Efficacy of coronary artery bypass grafting combined with mitral valve surgery on moderate to severe ischemic mitral regurgitation

作　　者：韩越博 Han Yuebo(Department of Cardiac Surgery,the People's Hospital of Anyang,Anyang 455000,China)

机构地区：[1]河南省安阳市人民医院心脏外科,455000

出　　处：《临床医学》2022年第8期18-21,共4页Clinical Medicine

摘　　要：目的探讨中重度缺血性二尖瓣关闭不全(IMR)采取冠状动脉旁路移植术(CABG)中同期二尖瓣手术(MVS)治疗的效果。方法选择2016年6月至2021年8月安阳市人民医院收治的82例中度至重度IMR患者为研究对象。所有患者均接受CABG联合MVS治疗,根据MVS方式分为对照组与观察组,每组41例。对照组实施二尖瓣成形术(MVP),观察组实施二尖瓣置换术(MVR)。比较两组的治疗效果。结果两组主动脉阻断时间、体外循环时间、呼吸机辅助时间、ICU时间、住院时间比较,差异未见统计学意义(P>0.05)。两组主动脉内球囊反搏辅助率、连续肾替代治疗应用率及临时起搏器应用率比较,差异未见统计学意义(P>0.05)。两组脑血管意外、肺部感染、急性肾衰竭、室性心律失常等术后并发症发生率比较,差异未见统计学意义(P>0.05)。随访半年,观察组复发率低于对照组,差异有统计学意义(P<0.05)。结论中度至重度IMR患者采取CABG联合MVS治疗均有不错的效果,MVR相比MVP方案,在时间指标、术后并发症、辅助支持等方面效果相当,但可减少复发。Objective To investigate the efficacy of coronary artery bypass grafting(CABG)combined with mitral valve surgery(MVS)on moderate to severe ischemic mitral regurgitation(IMR).Methods Eighty-two patients with moderate to severe IMR admitted to Anyang People’s Hospital from June 2016 to August 2021 were selected.All patients received CABG combined with MVS,and were divided into control group and observation group according to MVS,with 41 cases in each group.Mitral valvuloplasty(MVP)was performed in the control group,and mitral valve replacement(MVR)was performed in the observation group.The therapeutic effects of the two groups were compared.Results There was no significant difference in aortic occlusion time,cardiopulmonary bypass time,ventilator assisted time,ICU time and hospitalization time between the two groups(P>0.05).There was no significant difference in IABP assist rate,CRRT application rate and temporary pacemaker application rate between the two groups(P>0.05).There was no significant difference in the incidence of postoperative complications such as cerebrovascular accident,pulmonary infection,acute renal failure and ventricular arrhythmia between the two groups(P>0.05).After half a year of follow-up,the recurrence rate of the observation group was lower than that of the control group,and the difference was significant(P<0.05).Conclusions CABG combined with MVS has good effect on patients with moderate to severe IMR.Compared with MVP,MVR has similar effects on time indicators,postoperative complications,and auxiliary support,but can reduce recurrence.

关 键 词：中度至重度 缺血性二尖瓣关闭不全 冠状动脉旁路移植术 二尖瓣手术 疗效 

分 类 号：R654.2[医药卫生—外科学]