经皮球囊二尖瓣扩张术并发症及防治对策

Complications of Percutaneous Balloon Mitral Valvotomy and Their Management

目的：探讨经皮球囊二尖瓣扩张术(PBMV)并发症防治对策。方法：对1995年1月至2004年12月的PBMV并发症相关中文文献进行meta分析研究。结果：共纳入15432例患者,发生心脏穿孔或心包填塞162例(1．049%),死亡6例；动脉栓塞71例(0．460%),死亡7例；左心衰竭和急性肺水肿32例(0．207%),死亡3例；中重度二尖瓣关闭不全689例(4．465%),死亡2例；严重心律失常76例(0．493%),死亡1例；房间隔左向右分流106例(0．687%),死亡2例；低血压及一过性脑缺血发作372例(2．412%)。结论：心包填塞、动脉栓塞,左心衰竭和急性肺水肿、二尖瓣关闭不全、严重心律失常、房间隔左向右分流是PBMV的最常见并发症及围术期死亡的主要原因,是防治的重点。

Objective： To study the mechanism and the management of complications of percutancous balloon mitral valvotomy（ PBMV）. Methods： Chinese literatures about PBMV during January, 1995, and December, 2004 were selected and mata-analyzed. Results： A total of 65 articles（ included 15432 patients）were reviewed in this study. 162（1.049%, 6 death）Perforation of cardiac muscle and tamponde, 689（ 4.65%, 2 death）mitral valve regurgitation, 71（0. 460%, 7death） systemic thromboembolism, 76（ 0. 493 %, 1death）sever arrhythmia, 32（ 0. 207%, 3 death）acute heart failure and pomonary edema, 106（ 0. 687%, 2 death） acute artial septal defect, 372（ 2. 412% ） hypotension and transient ischemic track were reported. Conclusion： Perforation of cardiac muscle, mitral valve regurgitation, systemic thromboembolism, sever arrhythmia, acute heart failure, acute artial septal defect, hypotension and transient ischemic track were major events and the key to prevent and to manage in PBMV among all complications.