二尖瓣成形术及二尖瓣置换术治疗风湿性二尖瓣病变的近期效果比较  

Comparison of short-term effects of mitral valvuloplasty and mitral valve replacement on rheumatic mitral valve disease

作　　者：罗统波 陈凯明[1] 赖锋华[1] 刘浪[1] 朱伯卫[1] LUO Tongbo;CHEN Kaiming;LAI Fenghua;LIU Lang;ZHU Bowei(Area 3 of Cardiovascular Surgery Department,Gaozhou People's Hospital,Maoming 525299,Guangdong,China)

机构地区：[1]高州市人民医院心血管外科三区,广东茂名525299

出　　处：《外科研究与新技术》2023年第4期247-250,共4页Surgical Research and New Technique

基　　金：茂名市科技计划项目(230428154551578)。

摘　　要：目的探究二尖瓣成形术及二尖瓣置换术治疗风湿性二尖瓣病变的近期效果。方法选取2019年7月—2023年6月收治的风湿性二尖瓣病变患者400例作为研究对象。200例实施二尖瓣成形术(研究组),200例实施二尖瓣置换术(对照组),比较两组患者心功能、术中相关指标、住院时间、二尖瓣反流情况和并发生发生情况。结果治疗前研究组左心室舒张内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)、左房内径(LAD)与对照组比较差异无统计学意义(P>0.05),治疗后研究组各指标均优于对照组(P<0.05);研究组手术术中出血量和住院时间少于对照组,体外循环时间和手术时间长于对照组,差异有统计学意义(P<0.05);研究组二发生3例二尖瓣中度反流,15例轻度反流,发生率低于对照组,差异有统计学意义(P<0.05);研究组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论二尖瓣成形术治疗风湿性二尖瓣病变效果更佳,可促进患者术后恢复,安全性高,心功能改善更明显,值得临床推广。Objective To explore the short-term effects of mitral valvuloplasty and mitral valve replacement for rheumatic mitral valve lesions.Methods A total of 400 patients with rheumatic mitral valve lesions admitted from July 2019 to June 2023 were selected as study subjects and divided into two groups,including 200 cases with mitral valvuloplasty(study group)and 200 cases with mitral valve replacement(control group).The cardiac function,surgical indexes,hospital stay,mitral regurgitation,and complications were compared between the two groups.Results The preoperative left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular ejection fraction(LVEF),and left atrial diameter(LAD)of the study group did not differ from those of the control group(P>0.05),and the postoperative indicators of the study group were higher than those of control group(P<0.05).The amount of intraoperative bleeding and hospitalization time of the study group were less than those of the control group,but the duration of extracorporeal circulation and the duration of operation of the study group were longer than those of the control group(P<0.05).Moderate mitral regurgitation occurred in 3 cases and mild mitral regurgitation in 15 cases in the study group,and the incidence rate of mitral regurgitation of the study group was lower than that of the control group(P<0.05).The rate of complications of the study group was lower than that of the control group(P<0.05).Conclusion Mitral valvuloplasty is more effective in the treatment of rheumatic mitral valve lesions than mitral valve replacement by facilitating recovery with high safety and obviously improved cardiac function,and is worthy of clinical promotion.

关 键 词：二尖瓣成形术 二尖瓣置换术 风湿性 二尖瓣病变 近期效果 

分 类 号：R615[医药卫生—外科学]