二维超声心动图对二尖瓣狭窄闭式分离术后的远期疗效观察

OBSERVATION ON THE LONG一TERM EFFECTS AFTER CLOSED MITRAL COMMISSUROTOMY WITH TWO一DIMENTIONAL ECHOCARDIOGRAPHY IN MITRAL STENOSIS

用二维超声心动图定量测定６４例闭式二尖瓣分离术前后二尖瓣口面积（ＭＶＯ），并跟踪观察７年。结果表明：术后ＭＶＯ、瓣口前后径、横径均明显扩大（Ｐ＜０．００１）。术后３个月ＭＶＯ进一步扩大；６个月至１年上述指标基本稳定；术后３年ＭＶＯ较前缩小，再狭窄率为７％；术后５～７年再狭窄率６７％，但均值仍较术前大（Ｐ＜０．０５）。术后３个月至５年新出现二尖瓣关闭不全３例，主动脉瓣关闭不全６例。认为二尖瓣闭式分离术近期疗效良好，远期再狭窄率高。

he mitral valve orifices(MVOS)were preoperatively and postoperatively measured with two 一dimentional echocardiogaphy(2一DE)in 64 patients who underwent closed mitral commissuro tomy, Some patients had beem followed up for 7 years. Both MVOs andthe longitudinal and hori-zontal diameters were significantly enlarged (P<0.001)after operation, and MVOs enlarged pro-gressively until 3 months and then became stable during 6一12 months after the operation. MVOs were decreased with restenosis rate of 7%after 3 years and of 67%after 5一7years of the opera-tion ,respectively, but still larger than that before operation(P<0. 05).3 cases of mitral regurgi-tation and 6 cases of aortio valve regurgitation occturred during 3 months一5years after opera-ion. It was concluded that the closed miral commissurotomy had a quite good immediate effects after operation, but the restenosis rate was still higher after 5 years.