二尖瓣狭窄伴轻度反流患者经皮二尖瓣球囊扩张术及远期疗效观察.docVIP

二尖瓣狭窄伴轻度反流患者经皮二尖瓣球囊扩张术及远期疗效观察 　　作者：王崇全，党书毅，周荣华，彭贵海，王 斌 作者单位：郧阳医学院附属太和医院心内科，湖北 十堰 442000 　　【摘要】 目的：探讨伴轻度反流(MR) 的二尖瓣狭窄(MS)患者经皮二尖瓣球囊扩张术(PBMV)术后及长期疗效。方法：采用改良Inoue方法，自1993年5月~2001年12月对MS合并轻度MR的41例患者行PBMV治疗，并进行超声心动图和临床心功能评价。结果：二尖瓣口面积(MVA)由(1.15±0.25) cm2 增至(1.88±0.32) cm2 ( P0.001 );二尖瓣跨瓣压差(MVG)由(19.3±5.2) mmHg 降至(7.6±3.2) mmHg (P0.001 );左心房内径(LAD)由(4.78±0.63) cm 减小到(4.21±0.48) cm (P0.001 );心功能由(2.56±0.50) 级改善至(1.54±0.60) 级(P0.001 ) ; 左室内径(LVD)无明显变化(P0.05 )， 22例二尖瓣反流减轻或消失，15例二尖瓣反流维持不变，4例二尖瓣反流加重，无患者行急诊或择期二尖瓣置换术。41例患者随访时间9~112个月，平均(90±24)个月,MVA、MVG、MLAP、LAD、LVD和心功能与术后比较,均无明显变化(P0.05) ，1例于术后15个月时死亡，4例再狭窄，再狭窄率为9.76%。结论：选择好病例,把握球囊扩张尺度,风湿性心脏病二尖瓣狭窄伴轻度反流患者PBMV 近、远期疗效好。 　　【关键词】 二尖瓣狭窄 　　Evaluation on short-term and long-term clinical results after percutaneous balloon mitral valvuloplasty in 41 patients with mitral valve stenosis and mild mitral valve regurgitation WANG Chong-quan, DANG Shu-yi, ZHOU Rong-hua, et al. (Department of Cardiology, Taihe hospital, Yunyang Medical College, Shiyan, Hubei 442000, China) 　　Abstract：Objective Evaluation on short-term and long-term clinical results after percutaneous balloon mitral valvuloplasty(PBMV) in patients with mitral valve stenosis (MS) and mild mitral valve regurgitation (MR). Methods From May 1993 to December 2001, forty-one patients with MS and mild MR were performed PBMV with the improved Inoue way, echocardiography was done initially and within long-term follow-up period. Results Successful rate of PBMV was 100 %. The mean mitral valve area was (1.15±0.25) cm2 before PBMV vs (1.88±0.32)cm2 after PBMV immediately vs (1.79±0.45 )cm2 during follow-up,mean mitral valve gradient was (19.3±5.2)mmHg vs (7.6±3.2 )mmHg vs (8.1±4.1 )mmHg, respectively,mean left atrial diameter were (4.78±0.63)cm vs (4.21±0.48)cm vs (4.25±0.52)cm, respectively,mean cardiac function (NYHA) was (2.56±0.50) vs (1.54±0.60) vs (1.59±0.63), respectively. The regurgitation in 22 cases disappeared or became more mild after the procedure. 4 cases bec