CAJ | 학술논문

目的探讨MC3瓣膜成形环在治疗功能性三尖瓣关闭不全(FTR)中的临床应用效果.方法回顾性分析郑州大学第一附属医院2012年1月至2014年1月因FTR接受MC3瓣膜成形环三尖瓣成形术的85例患者资料,其中三尖瓣中度反流45例,重度反流40例.通过超声心动图检查,比较术前、术后早期及术后1年三尖瓣反流面积/右心房面积比、右心房横径、三尖瓣环左右径及右心室横径变化情况.结果术后早期三尖瓣轻度反流81例,中度反流4例.术后1年三尖瓣轻度反流82例,中度反流3例.与术前相比,术后早期及术后1年三尖瓣反流面积/右心房面积比率[(14.9±4.6)％、(13.1±4.3)％比(37.7±8.2)％,均P＜0.05]均显著减少,而右心房横径[(37.2±4.9)、(29.6±5.6)比(42.5±6.1)mm,均P＜0.05]、三尖瓣环左右径[(27.3±1.0)、(27.2±1.0)比(32.2±2.4)mm,均P＜0.05]、右心室横径[(35.5±3.7)、(28.1±4.0)比(36.9±3.4)mm,均P＜0.05]也均显著减小.与术后早期相比,术后1年三尖瓣反流面积/右心房面积比率、右心房横径及右心室横径也均减少,差异均有统计学意义(均P＜0.05),而三尖瓣环左右径差异无统计学意义(P＞0.05).随访期间无三尖瓣成形术相关并发症发生.结论对于功能性三尖瓣关闭不全,应用MC3瓣膜成形环进行三尖瓣成形术具有较好的临床效果.
목적 탐토MC3판막성형배재치료공능성삼첨판관폐불전(FTR)중적림상응용효과.방법 회고성분석정주대학제일부속의원2012년1월지2014년1월인FTR접수MC3판막성형배삼첨판성형술적85례환자자료,기중삼첨판중도반류45례,중도반류40례.통과초성심동도검사,비교술전、술후조기급술후1년삼첨판반류면적/우심방면적비、우심방횡경、삼첨판배좌우경급우심실횡경변화정황.결과 술후조기삼첨판경도반류81례,중도반류4례.술후1년삼첨판경도반류82례,중도반류3례.여술전상비,술후조기급술후1년삼첨판반류면적/우심방면적비솔[(14.9±4.6)％、(13.1±4.3)％비(37.7±8.2)％,균P＜0.05]균현저감소,이우심방횡경[(37.2±4.9)、(29.6±5.6)비(42.5±6.1)mm,균P＜0.05]、삼첨판배좌우경[(27.3±1.0)、(27.2±1.0)비(32.2±2.4)mm,균P＜0.05]、우심실횡경[(35.5±3.7)、(28.1±4.0)비(36.9±3.4)mm,균P＜0.05]야균현저감소.여술후조기상비,술후1년삼첨판반류면적/우심방면적비솔、우심방횡경급우심실횡경야균감소,차이균유통계학의의(균P＜0.05),이삼첨판배좌우경차이무통계학의의(P＞0.05).수방기간무삼첨판성형술상관병발증발생.결론 대우공능성삼첨판관폐불전,응용MC3판막성형배진행삼첨판성형술구유교호적림상효과.
Objective To evaluate the clinical efficacy of tricuspid valve (TV) annuloplasty with MC3 valve ring for management of functional tricuspid regurgitation(FTR).Methods A total of 85 patients who accepted TV annuloplasty with MC3 valve ring for management of FTR were retrospectively analyzed,of which included moderate tricuspid regurgitation (TR) (45 cases) and severe TR (40 cases).The ratio of regurgitant area to RA area,right atrium and ventricular transverse diameter,annulus diameter were measured by echocardiography at three different stages:before,early stage and 1 year after operation.Results At early stage after operation,there were 81 cases of mild TR,4 cases of moderate TR.At 1 year after operation,there were 82 cases of mild TR,3 cases of moderate TR.Compared with the results of pre-operation,the ratio of regurgitant area to RA area,right atrium transverse diameter,annulus diamete and right ventricular transverse diameter at early stage and 1 year after operation were significantly reduced ((14.9±4.6)％ and(13.1 ±4.3)％ vs(37.7±8.2)％,(37.2±4.9)and(29.6±5.6)vs (42.5 ±6.1)mm,(27.3 ± 1.0)and(27.2 ± 1.0)vs(32.2 ± 2.4) mm,(35.5 ±3.7)and(28.1 ±4.0)vs (36.9 ± 3.4) mm,all P ＜ 0.05).The ratio of regurgitant area to RA area,right atrium and ventricular transverse diameter at early stage after operation were significantly reduced than at 1 year after operation(all P ＜ 0.05),but there was no significant difference in the annulus diameter between early stage and 1 year after operation(P ＞ 0.05).No complications occurred during follow-up.Conclusion TV annuloplasty with MC3 valve ring is effective for the management of FTR.