应用二尖瓣成形环治疗二尖瓣反流25例分析

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1、应用二尖瓣成形环治疗二尖瓣反流25例分析韦成信曹健斌李逢昌李富骊石磊黄维佳陈俞宏(广丙壮族自治区柳州市人民医院545006)【摘要】目的：总结应用二尖瓣成形环行二尖瓣成形手术治疗二尖瓣反流行的临床经验及疗效。方法：2011年4月至2013年12月，25例二尖瓣中重度反流患者进行二尖瓣成形手术，男11例，女14例；年龄18〜65(52±4.1)岁。病因包括先天性二尖瓣关闭不全3例，瓣叶弹性纤维退行性变致瓣叶脱垂、腱索断裂或冗长致瓣叶脱垂17例，感染性心内膜炎5例。合并房颤13例，三尖瓣中重度反流11例。结果：无住院死亡患者。术后随访1〜31个月，平均(15.2±13

2、.6)个月。同术前相比，患者术后二尖瓣反流情况明显减轻，左心房和左心室内径明显缩小，射血分数明显增加，心功能状态明显改善。结论：联合应用二尖瓣成形环对二尖瓣关闭不全患者进行手术治疗，并发症少，恢复效果好,术后无需长期抗凝，是治疗单纯二尖瓣关闭不全患者的理想手术方式。【关键词】二尖瓣反流二尖瓣成形二尖瓣成形环【中图分类号】R615【文献标识码】A【文章编号】1672-5085(2014)12-0027-02ClinicalAnalysisAboutTreatmentofMitralRegurgitationWithAnnuloplastyRingin25PatientsWeicheng-xin

3、,Caojian-bing,Lifeng-chang,Lifu-li,Shilei,Huangwei-jia,Chenyu-hongDepartmentofCardiothoracicSurgery,PeopleHospitalofLiuzhou,Guangxi(545006)【Abstract】Objective:Thisstudywasperformedtoevaluatetheclinicalexperienceandeffectabouttreatmentofmitralregurgitationwithannuloplastyring.Metheds:FromApril2011to

4、December2013,25patients(including11malepatientsand14femalepatients)withmoderateorseveremitralregurgitationreceivedplasticoperation.Theaverageagewas52±4.lyears(range18〜65years).Prolapseofleafletcamefromdegenerationofelasticfibers,chordalruptureandchordalelongationwaspresentedin17patients.Othe

5、rcausesofmitralregurgitationwerecongenitalmitralinsufficiency(3patients)andinfectiveendocarditis(5patients).Theconcomitantdiseaseincludedatrialfibrillationin13patients,moderateorseveretricuspidregurgitationin11patients.Result:Duringthefellowupof1to30months(15.2±13.6),allpatientssurvived.Sign

6、ificantalleviationofmitralregurgitationwasobservedinallpatientsafterprocedureascomparedwithpreoperativedata.Echoshowedthediminutionofleftatrialdiameterandleftventricularenddiastolicdiameter,augmentationofejectionfraction,improvementofcardiacfunctionamongthesepatients.Conclusion:Theapplicationofannu

7、loplastyringinmitralannuloplastyhaslesscomplicationandstableclinicalresults.Thissurgicaltechniquewithoutlong-termanticoagulationisgoodtopatientwithmitralregurgitation.【Keywords]MitralregurgitationMitralannu