摘要
目的 探讨风湿性二尖瓣狭窄合并左房附壁血栓患者经皮二尖瓣球囊扩张术 (PBMV)的可行性。方法 对 10例确诊为风湿性二尖瓣狭窄合并左房附壁血栓的患者术前至少 4周开始用肠溶阿斯匹林 10 0mg/d和潘生丁 75mg/d ;肝素 10 0mg/d ,7～ 12天 ,1例患者同服华法令 3mg/d ,40天。术前复查超声心动图 (UCG)显示血栓机化。再通过Inoue方法行PBMV。结果 10例患者均取得满意效果。二尖瓣瓣口面积从 0 70± 0 12cm2 增加到 1 62± 0 2 0cm2 (P <0 0 0 1) ,左房内径从 6 70± 4 0 3cm回缩到 5 72± 3 43cm (P <0 0 0 1) ,左房平均压从 3 40± 0 90kPa下降至 2 2 0± 0 88kPa(P <0 0 1)。心功能从Ⅲ级提高到Ⅱ级 3例 ,提高到Ⅰ级 1例 ;从Ⅳ级提高到Ⅲ级 4例 ,提高到Ⅱ级 2例。无 1例出现心包填塞、动脉栓塞、明显的二尖瓣反流等并发症。结论 部分风湿性二尖瓣狭窄合并左房附壁血栓患者可以通过PBMV改善心功能。
Objective To investigate the feasibility of percutaneous ballon mitral valvuloplasy (PBMV)for patients with rheumatic mitral stenosis and left atrial thrombi. Methods 10 patients had been treated with aspine 100mg/d and persantin 75 mg/d for more than 4 weeks before PBMV,and 1 case was treated with warfarin 3mg/d at the same time for 40 days.Ultrasound cardiography demonstrated the thrombi organization.Then the operation of PBMV was performed with Inoue method on the 10 patients.Results All patients successfully underwent the procesure,the mean mitral valve area increased from 0.70±0.12cm 2 to 1.62±0.20cm 2(P<0.01),the mean left atrial diameter was reduced from 6.70±4.03cm to 5.72±3.43cm(P<0.01),and the mean left pressure was lowered from 3.40±0.90kPa to 2.20±0.88kPa(P<0.01).Heart function increased from ⅢtoⅡ in 3 patients,from ⅢtoⅠin 1 patient,fromⅣtoⅢ in 4 patients,and fromⅣtoⅡin 2 pateints.There were no complications of thrombembolia.Conclusion Some of the patients with rheumatic mitral stenosis and left atrial thrombi can have their heart function improved through PBMV.
出处
《四川医学》
CAS
2004年第1期68-69,共2页
Sichuan Medical Journal
关键词
风湿性二尖瓣狭窄
血栓
球囊扩张术
rheumatic mitral stenosis
thrombi
ballon
valvuloplasy
