再次经皮二尖瓣球囊成形术的临床疗效

Curative effect of repeated percutaneous ballon mitral valvuloplasty

目的:探讨二尖瓣球囊成形术的临床疗效。方法:对42例经皮二尖瓣球囊成形术(PBMV)后再狭窄的患者施行再次PBMV,并与随机抽取的同期首次接受PBMV的43例患者进行疗效比较。结果:两组患者PBMV均获成功,术后二尖瓣瓣口面积增加(P<0.01),左房平均压下降(P<0.01),肺动脉平均压、左房舒张末内径明显降低(P<0.05)。再次PBMV组二尖瓣瓣口面积增加值及肺动脉平均压下降值均小于首次PBMV组(P<0.05),但左房平均压、左房舒张末内径下降值相比无统计学差异。两组均无严重并发症发生。结论:提示再次PBMV仍是PBMV术后再狭窄患者一种安全有效的治疗手段。

Objective： To investigate Curative effect of repeated percutaneous ballon mitral valvuloplasty. Methods： Forty-two patients with mitral restenosis following a successful first percutaneous ballon mitral valvuloplasty（PBMV） underwent repeated PBMV,and were compared with 43 randomly selected homochronous patients who received an initial PBMV as control. Results. PBMV was successful in all the patients of the two groups, producing an increase in mitral valve area （MVA） （P 〈 0. 01）, a decline in mean left atrial pressure （LAMP） （P 〈 0. 01）, and a notable reduction in both mean pulmonary arterial pressure （PAMP） and left atrial diameter （LAD） （P 〈 0.05）. The mean increment in MVA and reduction in PAP in the patients after repeated PBMV were both less than those in whom PBMV was an initial procedure （P 〈 0.05） ,but there was no statistical difference in the reduction of LAMP or LAD. And there was no seious complication in either group. Conclusion：Repeated PBMV is still a safe and effective therapeutic measure for patients with restenosis after initial PBMV.