12例二尖瓣成形术治疗二尖瓣关闭不全的临床研究

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1、授予单位代码10089学号或申请号20153240中国图书分类号R654.2HebeiMedicalUniversity硕士学位论文专业学位12例二尖瓣成形术治疗二尖瓣关闭不全的临床研究研究生：白杨导师：石凤梧教授专业：外科学（心胸外科方向）二级学院：河北医科大学第二医院2018年3月目录中文摘要·················································································1英文摘要·····························

2、····················································2英文缩写·················································································4研究论文12例二尖瓣成形术治疗二尖瓣关闭不全的临床研究前言·······················································································5材料与方法···

3、···········································································5结果·······················································································8附表·······················································································9讨论······

4、················································································11结论·····················································································14参考文献···············································································14综述二尖瓣成形治

5、疗二尖瓣关闭不全的研究进展···························19致谢·····················································································32个人简历···············································································33中文摘要12例二尖瓣成形术治疗二尖瓣关闭不全的临床研究摘要目的：总结2016年1月至2017年7

6、月于河北医大二院心脏外科行二尖瓣成形术的全部患者的临床数据及术后随访结果，客观评估成形术后的临床疗效。方法：入选患者共12例，其中男8例，女4例，年龄16～68岁。术前根据心脏彩超进行二尖瓣反流的分级，并根据患者的症状进行心功能（ＮＹＨＡ分级）分级。本组全部患者均在全麻+中低温体外循环下行手术治疗，若合并冠心病、先心病及其他瓣膜病则同时处理。成形完毕后，用盐水测试及经食道心脏彩超评价成形效果。术后通过复查心脏彩超随诊。结果：全组患者出院前均未发生手术并发症及死亡。术后随访11例，因成形效果不佳改行人工瓣膜置换术的1例患者未

7、随访，随访率91.7%，随访时间6--24个月。术后复查超声心动图，1例患者于成形术后5个月复发，二尖瓣反流为中度。其余患者二尖瓣均未见轻度以上反流，术后左心房内径、左心室收缩期内径与容积及舒张期内径与容积相较于术前相关数据均明显缩小。结论：联合应用人工瓣环、瓣叶切除及人工腱索的综合二尖瓣成形可取得良好的手术效果，消除或明显减轻二尖瓣反流程度，并减轻左室前负荷，使左心各腔室的内径与容积明显减小。关键词：二尖瓣关闭不全,二尖瓣反流,二尖瓣成形,瓣膜手术,外科手术1英文摘要ClinicalAnalysisofMitralVal

8、vuloplastyin12CasesABSTRACTObjective:ByperformingaretrospectiveanalysisofpatientsundergoingmitralvalvuloplastyfromJanuary2016toJuly2017inDepartmentofCar