CAJ | 학술논문

目的：总结二尖瓣成形术在成人二尖瓣反流治疗中的临床疗效。方法回顾性分析2010年12月至2012年6月56例成人二尖瓣反流患者行二尖瓣成形术治疗的临床资料。成形术包括人工瓣环置入，瓣叶部分切除，腱索修复、转移，人工腱索置入，缘对缘缝合技术等。术中行左心室注水试验及经食管超声心动图检查评估效果。出院后门诊随访，超声心动图观察心功能及二尖瓣反流程度。结果全组围手术期无死亡。出院时心功能均明显改善，心功能（NYHA分级）Ⅰ级47例，Ⅱ级9例。术后随访52例，随访率为92.9%，随访时间18~36个月。术后1年超声心动图提示左心房内径[（35.5±5.5）mm vs.（50.6±5.7）mm]、左心室舒张期末内径[（52.9±6.4）mm vs.（66.5±6.4）mm]、左心室收缩期末内径[（35.1±6.3）mm vs.（49.8±6.0）mm]与术前比较明显缩小，左心室射血分数[（61.0±7.0）%vs.（52.0±8.0）%]与术前比较明显提高。结论成人二尖瓣反流采用二尖瓣成形术可取得满意的临床疗效，改善心功能。
목적：총결이첨판성형술재성인이첨판반류치료중적림상료효。방법회고성분석2010년12월지2012년6월56례성인이첨판반류환자행이첨판성형술치료적림상자료。성형술포괄인공판배치입，판협부분절제，건색수복、전이，인공건색치입，연대연봉합기술등。술중행좌심실주수시험급경식관초성심동도검사평고효과。출원후문진수방，초성심동도관찰심공능급이첨판반류정도。결과전조위수술기무사망。출원시심공능균명현개선，심공능（NYHA분급）Ⅰ급47례，Ⅱ급9례。술후수방52례，수방솔위92.9%，수방시간18~36개월。술후1년초성심동도제시좌심방내경[（35.5±5.5）mm vs.（50.6±5.7）mm]、좌심실서장기말내경[（52.9±6.4）mm vs.（66.5±6.4）mm]、좌심실수축기말내경[（35.1±6.3）mm vs.（49.8±6.0）mm]여술전비교명현축소，좌심실사혈분수[（61.0±7.0）%vs.（52.0±8.0）%]여술전비교명현제고。결론성인이첨판반류채용이첨판성형술가취득만의적림상료효，개선심공능。
Objective To summarize the clinical experience and evaluate the value of early and midterm mitral valve repair in adult mitral regurgitation. Methods The in-patient data and follow-up outcomes of 56 patients after mitral valve repair of mitral regugitation from December 2010 to June 2012 were analyzed retrospectively. The operative tech-niques included annular ring implantion, partial resection of the leaflet, chordea repair, chordae transposition, artificial chordae replacement, edge to edge. The results were evaluated by saline injection test and transesophageal echocardiogra-phy. Patients were followed by echocardiography afterwards to evaluate heart function and degree of mitral regurgitation. Results There was no in-hospital death in this group. When discharged from hospital, heart function was improved sig-nificantly. Fifty-two patients were followed up with a follow-up rate of 92.9% for 18~36 months. The echocardiography 1 year after discharge showed remarkable reduction in left atrial diameter [(35.5±5.5)mm vs. (50.6±5.7)mm], left ventricular end-diastolic diameter [(52.9 ±6.4)mm vs. (66.5 ±6.4)mm], left ventricular end-systolic diameter [(35.1 ±6.3)mm vs. (49.8 ± 6.0)mm], and remarkable increase of left ventricular ejection fraction [(61.0±7.0)%vs. (52.0±8.0)%] compared with those before operation. Conclusion Mitral valve repair can achieve effective clinical results and improve heart function for adult mitral regurgitation.