中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2013年
5期
761-768
,共8页
夏冰%文冰%许华山%付国伟%赵文增
夏冰%文冰%許華山%付國偉%趙文增
하빙%문빙%허화산%부국위%조문증
器官移植%心肺移植%组织移植%自体心包补片%钙化性主动脉瓣狭窄%心脏瓣膜假体%主动脉瓣环%主动脉瓣置换%超声心动图%器官移植图片文章
器官移植%心肺移植%組織移植%自體心包補片%鈣化性主動脈瓣狹窄%心髒瓣膜假體%主動脈瓣環%主動脈瓣置換%超聲心動圖%器官移植圖片文章
기관이식%심폐이식%조직이식%자체심포보편%개화성주동맥판협착%심장판막가체%주동맥판배%주동맥판치환%초성심동도%기관이식도편문장
背景:在主动脉置换过程中常遇到瓣环钙化、瓣周囊肿等特殊情况,这时一般应用特殊技术辅助主动脉瓣置换.目的:观察自体心包补片修补主动脉瓣环辅助主动脉瓣置换治疗钙化性主动脉瓣狭窄并瓣环钙化的临床可行性.方法:回顾性分析2009年1月至2012年1月郑州大学第一附属医院42例钙化性主动脉瓣狭窄并瓣环钙化患者的临床资料,并通过统计学软件处理自体心包补片修补主动脉瓣环技术辅助主动脉瓣置换前后的主动脉瓣有效瓣口面积指数、最大跨瓣压差、血流峰值速度、左室射血分数等数据,分析自体心包补片修补主动脉瓣环技术辅助主动脉瓣置换的应用效果.结果与结论:无置换中死亡病例,置换中主动脉阻断时间为52-88(63.0±18.1) min,体外循环时间为78-122(102.6±25.1) min,置换后1例患者出现急性肾功能衰竭,经床旁血透治疗后治愈.余患者无严重置换并发症.置换后住院天数为7-20(13.6±5.5) d.置换后多普勒超声心动图示:瓣膜功能良好,均未发现主动脉瓣周漏.置换后6个月的主动脉瓣有效瓣口面积指数、最大跨瓣压差、血流峰值速度、左室射血分数均有显著改善,与置换前比较差异均有显著性意义(P <0.05).证实对置换适应证合适的特殊换瓣患者,自体心包补片修补主动脉瓣环辅助主动脉瓣置换可取得满意的外科治疗效果,且操作安全简单,是一项可行的技术.
揹景:在主動脈置換過程中常遇到瓣環鈣化、瓣週囊腫等特殊情況,這時一般應用特殊技術輔助主動脈瓣置換.目的:觀察自體心包補片脩補主動脈瓣環輔助主動脈瓣置換治療鈣化性主動脈瓣狹窄併瓣環鈣化的臨床可行性.方法:迴顧性分析2009年1月至2012年1月鄭州大學第一附屬醫院42例鈣化性主動脈瓣狹窄併瓣環鈣化患者的臨床資料,併通過統計學軟件處理自體心包補片脩補主動脈瓣環技術輔助主動脈瓣置換前後的主動脈瓣有效瓣口麵積指數、最大跨瓣壓差、血流峰值速度、左室射血分數等數據,分析自體心包補片脩補主動脈瓣環技術輔助主動脈瓣置換的應用效果.結果與結論:無置換中死亡病例,置換中主動脈阻斷時間為52-88(63.0±18.1) min,體外循環時間為78-122(102.6±25.1) min,置換後1例患者齣現急性腎功能衰竭,經床徬血透治療後治愈.餘患者無嚴重置換併髮癥.置換後住院天數為7-20(13.6±5.5) d.置換後多普勒超聲心動圖示:瓣膜功能良好,均未髮現主動脈瓣週漏.置換後6箇月的主動脈瓣有效瓣口麵積指數、最大跨瓣壓差、血流峰值速度、左室射血分數均有顯著改善,與置換前比較差異均有顯著性意義(P <0.05).證實對置換適應證閤適的特殊換瓣患者,自體心包補片脩補主動脈瓣環輔助主動脈瓣置換可取得滿意的外科治療效果,且操作安全簡單,是一項可行的技術.
배경:재주동맥치환과정중상우도판배개화、판주낭종등특수정황,저시일반응용특수기술보조주동맥판치환.목적:관찰자체심포보편수보주동맥판배보조주동맥판치환치료개화성주동맥판협착병판배개화적림상가행성.방법:회고성분석2009년1월지2012년1월정주대학제일부속의원42례개화성주동맥판협착병판배개화환자적림상자료,병통과통계학연건처리자체심포보편수보주동맥판배기술보조주동맥판치환전후적주동맥판유효판구면적지수、최대과판압차、혈류봉치속도、좌실사혈분수등수거,분석자체심포보편수보주동맥판배기술보조주동맥판치환적응용효과.결과여결론:무치환중사망병례,치환중주동맥조단시간위52-88(63.0±18.1) min,체외순배시간위78-122(102.6±25.1) min,치환후1례환자출현급성신공능쇠갈,경상방혈투치료후치유.여환자무엄중치환병발증.치환후주원천수위7-20(13.6±5.5) d.치환후다보륵초성심동도시:판막공능량호,균미발현주동맥판주루.치환후6개월적주동맥판유효판구면적지수、최대과판압차、혈류봉치속도、좌실사혈분수균유현저개선,여치환전비교차이균유현저성의의(P <0.05).증실대치환괄응증합괄적특수환판환자,자체심포보편수보주동맥판배보조주동맥판치환가취득만의적외과치료효과,차조작안전간단,시일항가행적기술.
@@@@BACKGROUND: Annulus calcification and paravalvular cysts often appear during aortic valve replacement. At this time, special techniques are general y used to assist the aortic valve replacement. OBJECTIVE: To investigate the clinical feasibility of pericardium patch repaired aortic annulus to assist aortic valve replacement for the treatment of calcific aortic stenosis complicated by annulus calcification. METHODS: Forty two patients with calcific aortic stenosis complicated by annulus calcification were selected from the First Affiliated Hospital of Zhengzhou University during January 2009 and January 2012. Their clinical data were retrospectively analyzed. The effective orifice area index of aortic valve, maximum transvalvular pressure gradient, peak blood flow velocity and left ventricular ejection fraction were analyzed with statistical software before and after pericardium patch repaired aortic annulus assisted aortic valve replacement, and then the effect of autologous pericardium patch repaired aortic annulus to assist aortic valve replacement was analyzed. RESULTS AND CONLUSION: There was no intraoperative death during the pericardium patch repaired aortic annulus assisted aortic valve replacement. The intraoperative aortic clamping time was 52-88 (63.0±18.1) minutes, and the cardiopulmonary bypass time was 78-122 (102.6±25.1) minutes. One patient appeared acute renal failure after replacement, and cured after the bedside hemodialysis treatment. The rest patients had no serious complications. The length of hospital stay was 7-20 (13.6±5.5) days. The postoperative Doppler echocardiography showed the heart valve prosthesis was good, and no paravalvular leaks were found. The orifice area index of aortic valve, maximum transvalvular pressure gradient, peak blood flow velocity and left ventricular ejection fraction were significantly improved at 6 months after replacement, and the differences were significant when compared with those before replacement (P < 0.05). In patients with appropriate surgical indications, the autologous pericardium patch repaired aortic annulus assisted aortic valve replacement surgery can achieve satisfactory effects, and the operation is safe and simple, which is considered as a practicable technology.
