保留瓣下结构二尖瓣置换术的早期临床研究

摘要

Objective To compare the early postoperative hemodynamics of routine mitral valve replacement (MVR) with MVR. Methods 69 patients were divided into 2 groups according to preservation of the subvalvular structures or not during operation, including Group A: Preservation of the subvalvular structures;Group B:Completely resection of the mitral leaflets, chordae and tendineae, and papillary muscles. All patients were followed up with examination of two dimensional echocardiography and color Doppler. The parameters of left heart function were measured. Results All the patients were followed up with examination of two dimensional echocardiography and color Doppler. The parameters of left heart function were measured. Difference among the 2 groups were compared. Conclusion The postoperative influence on left heart function in MVRP group is better than that of normal MVR group.%目的 比较常规二尖瓣置换术与保留瓣下结构的二尖瓣置换术患者早期血流动力学的改变.方法 将69例行二尖瓣置换的患者随机分为A(保留瓣下结构的二尖瓣置换)、B(常规二尖瓣置换)两组,收集术前及术后心脏彩色超声检测左心功能的结果,并对主要指标进行对比分析.结果 两组病例手术前后左心室大小、舒张末期容量指数均明显下降,B组较时A组下降更为明显,且术后低心排综合征发生率及死亡丰明显降低(P<0.05).结论 保留瓣下结构的二尖瓣置换术治疗关闭不全为主的二尖瓣病变较不保留瓣下结构者更有利于心功能的保护.