经皮球囊成形术治疗二尖瓣狭窄93例

PERCUTANEOUS BALLOON MITRAL VALVULOPLASTY IN 93 PATIENTS WITHRHEUMATIC MITRAL STENOSIS

应用乳胶尼龙网球囊导管治疗风湿性心脏病二尖瓣狭窄９３例，女６３例，男３０例，平均年龄３８（１３～５９）岁。成功９０例。左心房平均压由２．１３±０．８１ｋＰａ降至０．２０±０．１７ｋＰａ（Ｐ＜０．０１），跨二尖瓣压差由１．６６±０．７５ｋＰａ降至０．３３±Ｏ．３６ｋＰａ（Ｐ＜０．０１），术后二尖瓣口面积由１．０９±０．２０ｃｍ２增加至２．００±０．４０ｃｍ２（Ｐ＜０．０１），术后１周超声复查，左心房内径由４．４９±０．８５ｃｍ减至４．１２±０．７６ｃｍ（Ｐ＜０．０５）。并发二尖瓣关闭不全８例，轻度５例，中度２例，重度１例。心房壁穿孔１例，术后并发右眼颞侧视网膜动脉分支栓塞１例。结果表明：经皮球囊二尖瓣成形术是治疗二尖瓣狭窄的有效方法之一。

Percutaneous balloon mitral valvuloplasty (PBMV)using the single rubber nylon balloonwas Performed in 93 patients with the rheumatic mitral stenosis. There were 63 females and 30 males, witha mean age of 38±6.8 years(13～59 years). The procedure was successful in 90 patients. After PBMV,the mean left atrial pressure decreased from 2.13±O. 81 to 0. 20±0. 47 kPa(P<0.01),The mean transmitral gradient decreased from 1.66±0.75 kPa to 0.33±0. 36kPa and the mitral valve area increasedfrorn 1. 09±0.20 to 2.00±0. 40 cm2(P<0. 01). The diameter of the left atrium decreased from 4.49±0. 85 cm to 4.12±0. 76cm (P<0.05) 1 week after PBMV. Perforation of the left atrium occurred in 1 patient. Mitral regurgitation developed in 8 patients,5 mild, 2 moderate and 1 severe. In 1 patient it was complicated by embolism in a temporal branch of the artery of right retina, The resuIts show that PBMV isone of the effcetive methods for the treatment of mitral stenois。