中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2010年
2期
112-115
,共4页
郑铁%王坚刚%郭可泉%孟旭
鄭鐵%王堅剛%郭可泉%孟旭
정철%왕견강%곽가천%맹욱
二尖瓣脱垂%外科手术
二尖瓣脫垂%外科手術
이첨판탈수%외과수술
Mitral valve prolapse%Surgical procedures,operative
目的 探讨治疗二尖瓣前叶脱垂的外科修复方法及治疗效果.方法 1998年11月至2007年10月对210例二尖瓣前叶脱垂患者行二尖瓣修复术,并在术前、术中、术后利用超声心动图对心脏结构及功能进行评价.结果 采用缘对缘技术修复二尖瓣前叶脱垂134例(63.8%).出院时心脏功能(纽约心脏病协会分级)Ⅰ级168例,Ⅱ级40例.随访1～150(25.7±29.0)个月,围术期死亡2例(0.95%).超声心动图检查显示,术前左心房舒张末径为(47.5±12.7)mm,术后1年减小为(37.7±9.2)mm(P＜0.05);术前左心室舒张末径为(67.7±10.3)mm,术后1年减小为(51.7±7.9)mm(P＜0.05);术前左心室射血分数为(52.2±6.4)%,术后1年提高为(62.2±3.2)%(P＜0.05);术前二尖瓣反流面积为(10.4±4.1)cm~2,术后1年减少为(4.1±1.7)cm~2(P＜0.01).结论 二尖瓣修复术治疗二尖瓣前叶脱垂可获得良好的手术效果.缘对缘技术修复二尖瓣前叶脱垂安全、有效.
目的 探討治療二尖瓣前葉脫垂的外科脩複方法及治療效果.方法 1998年11月至2007年10月對210例二尖瓣前葉脫垂患者行二尖瓣脩複術,併在術前、術中、術後利用超聲心動圖對心髒結構及功能進行評價.結果 採用緣對緣技術脩複二尖瓣前葉脫垂134例(63.8%).齣院時心髒功能(紐約心髒病協會分級)Ⅰ級168例,Ⅱ級40例.隨訪1～150(25.7±29.0)箇月,圍術期死亡2例(0.95%).超聲心動圖檢查顯示,術前左心房舒張末徑為(47.5±12.7)mm,術後1年減小為(37.7±9.2)mm(P＜0.05);術前左心室舒張末徑為(67.7±10.3)mm,術後1年減小為(51.7±7.9)mm(P＜0.05);術前左心室射血分數為(52.2±6.4)%,術後1年提高為(62.2±3.2)%(P＜0.05);術前二尖瓣反流麵積為(10.4±4.1)cm~2,術後1年減少為(4.1±1.7)cm~2(P＜0.01).結論 二尖瓣脩複術治療二尖瓣前葉脫垂可穫得良好的手術效果.緣對緣技術脩複二尖瓣前葉脫垂安全、有效.
목적 탐토치료이첨판전협탈수적외과수복방법급치료효과.방법 1998년11월지2007년10월대210례이첨판전협탈수환자행이첨판수복술,병재술전、술중、술후이용초성심동도대심장결구급공능진행평개.결과 채용연대연기술수복이첨판전협탈수134례(63.8%).출원시심장공능(뉴약심장병협회분급)Ⅰ급168례,Ⅱ급40례.수방1～150(25.7±29.0)개월,위술기사망2례(0.95%).초성심동도검사현시,술전좌심방서장말경위(47.5±12.7)mm,술후1년감소위(37.7±9.2)mm(P＜0.05);술전좌심실서장말경위(67.7±10.3)mm,술후1년감소위(51.7±7.9)mm(P＜0.05);술전좌심실사혈분수위(52.2±6.4)%,술후1년제고위(62.2±3.2)%(P＜0.05);술전이첨판반류면적위(10.4±4.1)cm~2,술후1년감소위(4.1±1.7)cm~2(P＜0.01).결론 이첨판수복술치료이첨판전협탈수가획득량호적수술효과.연대연기술수복이첨판전협탈수안전、유효.
Objective To evaluate the therapeutic effects of mitral valve repair for the treatment of the anterior learlet prolapse of mittsl valve.Methods From November 1998 to October 2007,210 patients with severe anterior leaflet prolapse of mitral valve underwent valve repair.The condition of valve was preoperative,intraoperative,and postoperative assessed with echocardiography.Results Edge-to-edge repair technique was used in 134 cases(63.8%).The cardiac function was NYHA class Ⅰ in 168 cases and class Ⅱ in 40 cases after operation.Patients were followuped for 1-150(25.7±29.0)months,two patients(0.95%)died of postoperative low cardiac output syndrome.Echocardiography examination indicated that the mean JP2postoperative left atrial diameter was(37.7±9.2)mm against the preoperative value of(47.5±12.7)mm(P＜0.05),the mean postoperative left ventricular end-diastolic diameter was (51.7±7.9)mm against the preoperative value of(67.7±10.3)mm(P＜0.05),the mean postoperative left ventrlcular ejection fraction was(62.2±3.2)%against the preoperative value of(52.2±6.4)%(P＜0.05),and the mean preoperative regurgitation area was(10.4±4.1)cm~2 against the postoperative value of (4.1±1.7)cm~2(P＜0.01).Conclusions Optimal outcome was achieved by appropriate edge-to-edge technique or other mitral valve repair techniques for anterior leaflet prolapse of mitral valve.Edge-to-edge technique is a reliable and efficient surgical technique.
