摘要
目的运用超声心动图技术及其对左心室舒张功能的分级评估二尖瓣微创修复手术纠治单纯二尖瓣脱垂患者左心室结构和功能的变化。方法纳入2016年1月至2017年5月在我院心胸外科接受二尖瓣微创修复术的单纯二尖瓣脱垂患者37例作为手术组,其中男25例、女12例,年龄(53.49±11.02)岁。另选择年龄、性别与之相匹配的34例正常体检者为对照组,其中男19例、女15例,年龄(54.26±8.33)岁。回顾性分析术前及术后1个月、3个月、6个月、1年的心脏超声数据,计算心功能参数并对左心室舒张功能分级,通过组间两两比较分析术后患者在左心结构和功能的改善情况。结果手术组患者术后左心室收缩、舒张期末内径,左心房内径、左心室容积较术前显著缩小;术后左心室和左心房的内径较术前显著缩小,但大于对照组;术后1个月射血分数较术前显著降低,随后恢复至正常水平;术后6个月和1年左心室舒张功能不全发生率显著低于术前,差异均有统计学意义(P<0.05)。结论单纯二尖瓣脱垂患者行微创修复术后,左心房、左心室结构重构的同时左心室收缩和舒张功能也有显著改善。
Objective To evaluate the changes of left ventricular structure and function by echocardiography and its grading of left ventricular diastolic function in patients with mitral valve prolapse treated by minimally invasive mitral valve repair. Methods By retrospective analysis, 37 patients including 25 males and 12 females aged 53.49±11.02 years with mitral valve prolapse who underwent minimally invasive mitral valve repair were as an operation group, and 34 healthy persons including 19 males and 15 females aged 54.26±8.33 years matched by age and sex were selected as a control group. Ultrasound parameters of every participant were routinely collected before operation, 1 month, 3 months, 6 months and 1 year after operation, and left ventricular diastolic function was graded. The ultrasound parameters between the two groups were compared. Results The diameters of left ventricular end systolic and diastolic phase, left atrial diameter and left ventricular volume in the operation group were significantly smaller than those before operation. The diameters of left ventricle and left atrium after operation were significantly shorter than those before operation, but they were still larger than those of the control group. The ejection fraction value decreased significantly at one month after the operation and then returned to normal level. The incidence of left ventricular diastolic dysfunction at 6 months and 1 year after operation was significantly lower than that before operation(P<0.05). Conclusion Minimally invasive repair for patients with mitral valve prolapse can significantly improve systolic and diastolic functions of left ventricle while reconstructing left atrial and left ventricular structures.
作者
姚莉萍
董莉亚
张丽
徐振
梅举
丁芳宝
YAO Liping;DONG Liya;ZHANG Li;XU Zhen;MEI Ju;DING Fangbao(Department of Cardiothoracic Surgery,Congming Brack of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai,200092,P.R.China;Department of Cardiothoracic Surgery,Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai,200092,P.R.China)
出处
《中国胸心血管外科临床杂志》
CAS
CSCD
2019年第10期958-962,共5页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
关键词
微创修复
二尖瓣脱垂
超声心动图
左心室舒张功能
Minimally invasive repair
mitral valve prolapse
echocardiography
left ventricular diastolic function
