应用不同瓣膜行二尖瓣置换术的效果比较  

Comparison of the effects of valves of different types in mitral valve replacement

作　　者：吴小永[1] 张满堂[1] 卢锋 李盼盼 Wu Xiaoyong;Zhang Mantang;Lu Feng;Li Panpan(Department of Cardiothoracic Surgery,Jiaozuo People's Hospital,Jiaozuo 454000,China)

机构地区：[1]焦作市人民医院心胸外科,焦作454000

出　　处：《中国实用医刊》2024年第19期15-18,共4页Chinese Journal of Practical Medicine

摘　　要：目的比较应用不同瓣膜(生物瓣膜、机械瓣膜)行二尖瓣置换术的效果。方法回顾性分析。抽取2015年1月至2022年12月于焦作市人民医院成功完成二尖瓣置换术治疗的103例患者,根据应用的瓣膜材料将患者分为生物组(62例)和机械组(41例)。两组术后1年均入院复查。查阅两组患者资料,比较围术期指标(体外循环时间、升主动脉阻断时间、手术时间)、手术前后炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平、血流动力学指标[左心房面积(LAA)、二尖瓣E峰血流速度(Emv)、二尖瓣平均跨瓣压差(MPGmv)],比较两组术后1年并发症发生率及再次手术率。结果两组体外循环时间、升主动脉阻断时间、手术时间比较差异未见统计学意义(P>0.05)。术后第7天,两组IL-6、TNF-α水平均较术前升高,但生物组IL-6、TNF-α水平低于机械组(P<0.05)。术后第7天,两组LAA、Emv及MPGmv水平均较术前降低,且生物组低于机械组(P<0.05)。生物组并发症总发生率(3.23%,2/62)低于机械组(17.07%,7/41),P<0.05。生物组再次手术率(1.61%,1/62)与机械组(0.00%,0/41)比较差异未见统计学意义(P>0.05)。结论二尖瓣置换术中采用生物瓣膜、机械瓣膜均可获益,但相较机械瓣膜,生物瓣膜可避免术后炎症因子水平升高,对患者血流动力学影响较好,且术后并发症发生率低。ObjectiveTo compare the outcomes of mitral valve replacement using different valves(biological heart valve,mechanical heart valve).MethodsA retrospective analysis was conducted,including 103 patients who underwent mitral valve replacement successfully in Jiaozuo People’s Hospital from January 2015 to December 2022.The selected patients were categorized into a biological valve group(62 cases)and a mechanical valve group(41 cases)according to the valve material used.Both groups underwent follow-up examinations one year postoperatively.The data of the two groups were reviewed,and perioperative indicators(extracorporeal circulation time,ascending aorta clamp time,operation duration),preoperative and postoperative levels of inflammatory factors,including interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α),hemodynamic indicators,including left atrial area(LAA),mitral valve E peak blood flow velocity(Emv)and mitral valve mean pressure gradient(MPGmv),were compared between the two groups.The incidence of complications and the reoperation rate one year postoperatively were compared between the two groups.ResultsThere was no significant difference in extracorporeal circulation time,ascending aorta clamp time,and operation duration between the two groups(P>0.05).On the 7th day postoperatively,both groups showed an increase in IL-6 and TNF-αlevels compared with preoperative levels,but the biological valve group had lower levels compared with the mechanical valve group(P<0.05).On the 7th day postoperatively,both groups exhibited decreases in levels of LAA,Emv,and MPGmv compared with preoperative levels,moreover,the biological valve group had lower LAA,Emv,and MPGmv than the mechanical valve group(P<0.05).The total incidence of complications in the biological valve group(3.23%,2/62)was lower than that in the mechanical valve group(17.07%,7/41),P<0.05.There was no statistically significant difference in the reoperation rate between the biological valve group(1.61%,1/62)and the mechanical valve group(0.00%,0/41),P>0.05.Co

关 键 词：二尖瓣 置换术 生物瓣膜 机械瓣膜 炎症 血流动力学 并发症 

分 类 号：R654.2[医药卫生—外科学]