经皮穿刺二尖瓣球囊成形术(PBMV)100例经验体会Percutaneous Balloon Mitral Valvuloplasly: The experience of 100 Patients
方唯一,于文信,旅朝霞,李新明,部德秀,徐文林,李贵海,于军
摘要(Abstract)：
我院采用Inoue单球囊法对100例风心病二尖瓣狭窄患者施行了PBMV治疗.患者中24例合并有轻度二尖瓣关闭不全,16例有轻度主动脉狭窄或关闭不全.术后患者血液动力学显著改善:左心房压从25.3±8.8降到12.4±6.3mmHg,跨二尖瓣压差17.1±7.1降至3.5±3.4mmHg,二尖瓣口面积从1.04±0.26扩大到2.08±0.32cm~2,心功能从2.8±0.5提高到1.3±0.5级.96%病例有双侧或单侧融合的二尖瓣双界被裂开.主要并发症有急性心包填塞(4例),严重二尖瓣返流(6例)和房间隔分流(4例).心包填塞主要是房间隔穿刺失误所致,严重二尖瓣返流多发生在瓣膜和融合的交界有明显钙化以及瓣下结构融合的病例,房间隔分流多为 二尖瓣扩张不理想所致.对于二尖瓣结构较好的患者,PBMV并不明显加重其原已存在的二尖瓣返流和主动脉瓣轻度病变.因此,掌握好房间隔穿刺技术、有效降低左心房压和选择好无明显瓣膜(尤其是瓣交界)钙化和瓣下严重融合的病例,是PBMV成功和减少严重并发症发生的重要保证.
关键词(KeyWords)： 二尖瓣球囊成形术;心包填塞;二尖瓣返流
基金项目(Foundation):
作者(Author): 方唯一,于文信,旅朝霞,李新明,部德秀,徐文林,李贵海,于军
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