PBMV:超声心动图上瓣膜损害的特征与疗效关系
翁昌鸿,侯玉清,刘伊丽,贾满盈,牛序芳,李崇信,谢志斌,张远慧,赖世忠,龚消冰
摘要(Abstract)：
48例风湿性心脏病二尖瓣狭窄者施行了经皮二尖瓣球囊扩张成形术(PBMV),4例因术中合并症未获成功(充血性心衰2例,心包填塞1例,房间隔穿刺失败1例).44例完成了手术.临床症状显著改善43例(43/44,97.7%),左心房平均压自3.1±0.8降至1.7±0.9kPa(P<0.001),二尖瓣跨瓣压差自2.3±0.8降至0.3±0.1kPa(P<0.001),二尖瓣口面积自0.9±0.4cm~2扩大至2.0±0.5cm~2(P<0.001).根据二尖瓣在超声心动图屏幕上的特征,44例病人分为3组:瓣膜柔软组16例;半柔软组23例和僵硬组5例.临床随访成功者症状持续改善第1组16例(100%);第2组22例(95%),与第1组比较P>0.05.第3组仅2例(40%),与第1,2组比较差异显著(P<0.01).轻度二尖瓣返流第1组1例(6%),第2组4例(17%),第3组3例(60%).根据二尖瓣在超声屏幕上的特征和临床疗效等多因素比较分析,我们认为PBMV对瓣膜柔软和半柔软者无疑是一种安全有效的治疗方法.然而瓣膜僵硬者宜行二尖瓣置换术.
关键词(KeyWords)： 经皮穿刺;二尖瓣球囊成形术;瓣膜损害;疗效关系
基金项目(Foundation):
作者(Author): 翁昌鸿,侯玉清,刘伊丽,贾满盈,牛序芳,李崇信,谢志斌,张远慧,赖世忠,龚消冰
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