经皮二尖瓣球囊成形术治疗伴重度钙化二尖瓣狭窄33例观察及护理

Clinical analysis and of percutaneous palloon mitral valvuloplasty for mitral stenosis complicated with severe calcification

目的 :观察风湿性心脏病 (RHD)伴重度钙化的二尖瓣狭窄 (MS)患者行经皮二尖瓣球囊成形术 (PBMV)的近期疗效及安全性。方法 :对 33例伴重度钙化的MS患者行逐步球囊扩张法PBMV治疗 ,术中监测左房平均压等 ,术前、术后 3个月进行心脏超声心动图检查 ,并对结果进行统计分析。结果 :术后左房压、二尖瓣跨瓣压差显著下降 ;超声心动图示二尖瓣口面积显著扩大 ,心功能显著改善 ,左房内径、二尖瓣跨瓣压差、肺动脉收缩压显著减小 ,左室内径无显著变化。结论 :逐步扩张法PBMV治疗伴重度钙化的MS是一种安全。

Objective: To study the efficacyted and safety of percutaneous balloon mitral vaivuloplasty (PBMV) in patients with mitral stenosis(MS) complicated with severe calcification. Methods: Thirty-three cases of MS with severe calcification were treated by gradual enlarge method of PBMV with Inoue single balloon, Left atrial pressure(LSP) and mitral valve gradient (MVG) were monitored during operation, Echocardiography were examined before and 3 months after PBMV. The data were statisticly analysed. Results: The left atrial pressure (LAP) and MVG decreased (p<0.01) significantly monitored during operation. After 3 months, Mitral valve area (MVA) increased (p<0.01) and the heart function classification (NYHA) improved (p<0.01) markedly, Left atrial diameter (LAD) and MVG and pulmonary artery pressure (PAP) decreased significantly (p<0.05 or p<0.01). There is no significant change in the end diastolic diameter of left ventricle. Conclusion: Gradual enlarge method of PBMV is an effective and safe measure in patients with MS complicated with severe caleification.