dor法切除左心室壁瘤对左心室形态和功能的影响

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1、～匦姥如醢主：坠室壁瘟越左：垒至瑟盔麴盐匪曲堑蛔(·tl,室锥度，C值)的变化。结果三组均无手术死亡。正常对照组术前、术后的EF、左一II,室容积、形态没有明显变化。室壁瘤组术后左一II,室容积明显减少，EF明显提高，从术前的0．43+0．06提高到术后的O，54士0．08(p=0．02)。左心室三维形态更接近类圆锥体(C值接近于1)，术后舒张末一II,室锥度从术前的O．36-土0．04提高到术后的O．56i0．04(p=0，02)，收缩末一Ii,室锥度从术前的O，42*0．03提高到术后的O60-a：0．05(p=0．03)。室壁瘤组心室形态改善最显著。结

2、论Dor法能有效改善左心室壁瘤患者的心功能和心室形态。三维超声可以作为一种精确、有效、经济的新手段进行心室形态的定量研究。关键词冠状动脉粥样硬化性心脏病左一II,室室壁瘤Dor法(心室成形术)三维心超2～垃蓬切睦杰坐蔓壁瘟越耋!坠室毖态曲齄盎鳇髭蛔Abstractobjective：ToevaluatetheeffectsoftheDorprocedureonleftventricularfunctionandshapewithtwo．．dimensionalandthree．．dimensionalechocardiographydatainpatient

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4、ryheartdiseaseweredividedintotwogroupsaccordingtothepreoperativedataoftheechocardiography．1．Dorgroup：patientswiththeleftventricularaneurysmweretreatedwithDorprocedure(wi也orwithoutCABG)(n228)，excludingthepatientswithmitralregurgitationorothervalvedisease；2．Controlgroup：patientswitha

5、normalcardiacfunctionandventriculardiameterwereunderwenttheOPCABonly(n=15)．111edataofthecardiacfunction(EFlandtwo·dimensionalventricularshapeindexwereanalyzedbeforeandafteroperation．Results：TheoperativemortalityrateofDorgroupWas7．1％．andthelatemortalityrateWas7．1％witha28．5monthsfoll

6、ow-up．EFincreasedfromO．37士0．09preoperativelyto0．49-士0．09postoperatively(p<0．01)．InDorgrouptheleftventricularshapebecamemoreellipticalafteroperationthanitWasbeforeoperation(eccentricityindexcloserto11．ThereWasnodeathincontrolgroup．ThereWasnoapparentchangeofEFandE1beforeandafteropera

7、tioninthisgroup．ThereWasnosignificantdifferenceofthepostoperativeEIbetweenthetwogroups．PARTⅡAprimaryresearchtoevaluatetheeffectsofDorprocedureonleftventricularfunctionandthree-dimensionalshape．Methods：FromMay2003toMarch2004，9patientswithcoronaryheartdiseaseweredividedintothreegroup

8、saccordingtothe3preopermiv