小左心室和大左心室患者进行相同机械二尖瓣置换术后围手术期血流动力学研究

Perioperative hemodynamics study of small left ventricle patients comparing with large left ventricle patients after mitral replacement

目的:探讨比较小左心室和大左心室患者进行大口径二尖瓣置换术的围手术期血流动力学变化。方法:进行单独二尖瓣置换术的患者按照左心室舒末径<40 mm、>40 mm而<60 mm和>60mm分为3组,均进行相同大小On-X二尖瓣置换。每组患者手术后均进行各瓣膜跨瓣压差、流速和肺动脉压的测定,最后用SPSS统计分析。结果:在进行同样大小二尖瓣置换后,3组心室大小不同的患者术后主动脉瓣流速、二尖瓣流速和肺动脉压力在各组间并没有统计学差异。结论:在注意心肌保护和围手术期处理的条件下,左心室舒张末径较小的患者和大左心室患者在接受较大口径机械二尖瓣置换时,围手术期血流动力学无明显差异。

Objective：To investigate the perioperative hemodynamie features of mitral replacement of patients with small left ventricles and large left ventricles. Method： Patients received same size On-X mitral replacement were divided into three groups according to their LVEDD less than 40 mm, between 40 mm and 60 mm and larger than 60 mm. The perioperative echo results were analysised with SPSS software. Result： The three groups of patients with different LVEDD have no significant difference in the aortic blood velocity, mitral blood velocity and pulmonary pressure. Conclusion：With the eausious perioperative treatment and myocardial protection, the patients with small left ventricle received the big mitral prosthesis got similar hemodynamies results as the patients with large left ventricles.