术前改良法测量主动脉瓣环内径与人工机械主动脉瓣大小的相关性研究

摘要

Objective:To analyze the correlation between aortic valve annulus diameter(AVAD)measured by improved method and the size of artificial aortic valve,and to compare the difference between the improved method and the traditional one. Methods:The AVAD of group A(18 cases)were measured by traditional method(left ventricular long axis view)and the AVAD of group B(21 cases)were measured by improved method(short axis section of aortic valve),then the difference of two groups was compared. The sizes of artificial valve used in the operation were recorded,and the correlations between the AVAD values and the sizes of artificial valve of two groups were analyzed. The hemodynamic changes of the artificial aortic valve in 1 week,3 month,6 month,and 12 month after operation and the short-term results of the two groups were obtained. Results:The correlation coefficient between AVAD and artificial aortic valve size was 0.66 in group A,and that was 0.79 in group B. The AVAD value of group B was significantly bigger than that of group B(P=0.005),but there was no statistical differ-ence between the two groups in the size of artificial aortic valve used in operation (P=0.324). The artificial aortic valve hemo-dynamics of group B was also better than that of group A. Conclusions:The accuracy of AVAD measurement by aortic short axis is superior to that by left ventricular long axis,and is helpful to guide the surgeon to select the appropriate size of the ar-tificial valve and reasonable operational manner,and to reduce the occurrence of prosthetic valve dysfunction.%目的:分析改良法测量主动脉瓣环内径与人工主动脉瓣大小的相关性,比较改良法与传统测量方法的差异.方法:2014年主动脉瓣置换术患者术前采用传统法(左室长轴切面)测量主动脉瓣环内径(A组,18例),2015年主动脉瓣置换术患者术前采用改良法(主动脉瓣短轴切面)测量(B组,21例),比较2组测量结果.记录术中所用人工瓣的型号,分析2组测量结果与人工瓣大小的相关性,比较2组间人工瓣大小的差异;追踪患者术后1周、3个月、6个月、12个月主动脉瓣口血流动力学的变化,比较2组人工瓣置换术后的近期效果.结果:A组主动脉瓣环内径与人工瓣大小的相关系数为0.66,B组为0.79.B组瓣环内径明显大于A组(P=0.005),但2组置换的人工瓣型号差异无统计学意义(P=0.324);术后1年内B组人工瓣血流动力学指标优于A组.结论:主动脉瓣短轴切面测量主动脉瓣环内径的准确性优于左室长轴切面,有助于外科医师选择手术方式和合适大小的人工瓣膜,减少人工瓣功能障碍的发生.