15例二尖瓣狭窄患者球囊二尖瓣成形术的临床观察

Clinical trial of percutaneous balloon mitral valvulosty(PBMV) in 15 cases of mitral valve stenosis

本文对１５的二尖瓣狭窄患者，经皮球囊二尖瓣成形术（ＰＢＭＶ）的效果及随访进行了观察。用日本ＩＮＯＵＥ和广东省医院制球囊导管，按常规方法在Ｘ线透视下，借助Ｂ超协助定位，术中进行持续压力监测及Ｂ超监测。术后随访一年半，观察Ｂ超、胸片、心电图等。１５例患者中，除１例因左房导丝（ＴＭＣ）脱位外，其余１４例成功。二尖瓣口面积由０．８２±０．１５ｃｍ２增至１．６９±０．３４ｃｍ２，左房容积缩小，二尖瓣跨瓣压差减少，肺动脉压下降，心尖区舒张期杂音明显减轻，术后恢复较好。经常规抗风湿治疗，无一例发生再狭窄。作者认为只要严格掌握适应证及防治风湿活动，ＰＢＭＶ在临床上是一有效的治疗方法。

The present paper reports on the efficacy of percutaneous balloon mitral valvulosty(PBMV) undertaken in 15 cases(male/female=7/8) of mitral valve stenosis with an average age of 37.7 years.A follow up was conducted of these patients using two-dimension ultrasound echocardiogram, chest X-ray film and electrocardiogram 1.5 year following surgery. One case was unsuccessful due to dislocation of TMC guiding wire and the remaining cases were successful. The two-dimension ultrasound echocardiogram revealed a significant dilation of mitral orifice from 0.82 ± 0.15 cm2 to 1.69 ± 0.34 cm2 and the volume of the left atrium and the pressure gradient across the mitral valve were decreased.The clinical symptoms of these patients were well improved and there was no detectable diastolic murmur.No restenosis was occurred following routine antirheumatic therapy. These results showed that PBMV is an effective treatment in clinical practice and patients reciving the treatment should be strictly indicated and undergo antirheumatic therapy.