经导管主动脉瓣置换术治疗重度主动脉瓣狭窄合并主动脉瓣关闭不全的效果  

Therapeutic effect of transcatheter aortic valve replacement on severe aortic valve stenosis complicated by aortic valve insufficiency

作　　者：张红伟 王艳[1] 龙慧珍[1] Zhang Hongwei;Wang Yan;Long Huizhen(Department of Cardiology,Henan Provincial Chest Hospital,Zhengzhou 450000,China)

机构地区：[1]河南省胸科医院心血管内科,郑州450000

出　　处：《中国实用医刊》2024年第3期1-4,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨经导管主动脉瓣置换术(TAVR)治疗重度主动脉瓣狭窄(AS)合并主动脉瓣关闭不全(AI)的效果。方法随机对照研究。抽取2022年3月至2023年3月河南省胸科医院收治的重度AS合并AI患者74例,按照随机数字表法分为对照组与研究组,每组37例。对照组采用外科主动脉瓣置换术治疗,研究组采用TAVR治疗。比较两组术前、术后6个月主动脉瓣指标[主动脉瓣流速(AV)、主动脉瓣瓣口面积(AVA)、主动脉瓣跨瓣峰值压差]、心功能[左心室舒张末期内径(LVEDD)、左心室后壁厚度(LVPWT)、左心室收缩末期内径(LVESD)]。比较两组并发症发生率。结果术后6个月,研究组AV、主动脉瓣跨瓣峰值压差低于对照组,AVA高于对照组(P<0.05)。术后3 d,研究组LVEDD、LVPWT、LVESD低于对照组(P<0.05)。研究组并发症发生率(5.41%,2/37)低于对照组(24.32%,9/37),差异有统计学意义(χ2=5.23,P=0.022)。结论TAVR用于重度AS合并AI患者中效果显著,能改善主动脉瓣指标和患者心功能,降低切口愈合不良、肺部感染等并发症发生风险。Objective To investigate the effect of transcatheter aortic valve replacement(TAVR)in the treatment of severe aortic valve stenosis(AS)complicated by aortic valve insufficiency(AI).Methods A total of 74 patients with severe AS complicated by AI treated in Henan Provincial Chest Hospital from March 2022 to March 2023 were selected for the randomized controlled study.And they were divided into the control group and the study group using a random number table method,with 37 cases in each group.The control group was treated by surgical aortic valve replacement,and the study group was treated by TAVR.The aortic valve indexes,including aortic valve velocity(AV),aortic valve opening area(AVA)and aortic valve peak transvalvular pressure difference,and cardiac function assessed by left ventricular end diastolic diameter(LVEDD),left ventricular posterior wall thickness(LVPWT)and left ventricular end systolic diameter(LVESD)were compared between the two groups before and 6 months after surgery.The incidence of complications of the two groups were copmpared.Results Compared with the control group,the AV and aortic valve peak transvalvular pressure difference in the study group were lower,but the AVA was higher 6 months after surgery(P<0.05).Compared with the control group,the LVEDD,LVPWT,and LVESD in the study group were lower 3 days after surgery(P<0.05).The incidence of complications in the study group(5.41%,2/37)was lower than that in the control group(24.32%,9/37),and the difference was significant(χ2=5.23,P=0.022).Conclusions TAVR has a significant effect in the treatment of severe AS complicated by AI,which can improve aortic valve indexes and cardiac function,and reduce the risk of complications,such as poor incision healing and pulmonary infection.

关 键 词：主动脉瓣狭窄 主动脉瓣关闭不全 经导管主动脉瓣置换术 

分 类 号：R654.3[医药卫生—外科学]