功能性三尖瓣反流的改良Devega成形环缩术与经典Devega环缩术疗效分析

Effectiveness of Surgical Tretment of Modified De Vega Technique and Traditional De vega Technique in Functional Tricuspid Regurgitation

目的通过超声比较改良Devega环缩术与经典Devega环缩术对三尖瓣反流术后的疗效。方法采用回顾性临床研究方法,选择2005年1月到2007年1月55例功能性三尖瓣反流的患者行Devega环缩术,行改良Devega环缩术组(改良组)25例与经典Devega环缩术组(经典组)30例。对术前、术后的下列指标进行比较:三尖瓣反流程度、心功能分级、左室射血分数。结果术后两组病人心功能较术前均有显著提高,差异无统计学意义(P>0.05),两组术后及随访射血分数均有轻度改善,差异无统计学意义(P>0.05),术后早期两组三尖瓣反流情况都较术前有明显减轻,但后期随访显示改良组远期效果优于经典组,经典组远期出现三尖瓣环缩反流加重情况,两组间差异有统计学意义(P<0.05)。结论三尖瓣改良Devega环缩术的成形效果优于经典Devega环缩术。

Objective To compare the efficacy of modified De vega technique and traditional De vega technique by echocardiography after tricuspid valve plastyic operation. Methods From January 2005 to January 2007,55 patients were treated with tricuspid valve plastic operation. The tricuspid regurgitation （TR） were functional and secondary in all patients. These patients were divided into modified De vega annuloplasty group （25 cases） , and trditional De vega annuloplasty group （30 cases） before opreation. The tricuspid annuloplasty, modified De vega annuloplasty and trditional De vega annuloplasty after opreation were compared. Result The Ridit analysis showed that there was no significant diffrenee about NYHA class between two groups （P 〉 0.05 ）. And the EF of left ventricular improved after opreation but there was no significant diference （ P 〉 0.05 ）. The proportion of TR degree improved in patients of two groups in a short - term. However, the difference of TR in long - term between two groups was statistically significant （ P 〈 0.05 ）. The outcome of modified De vega annuloplasty group was superior to traditional De vega technique. Conclusion The efficacy of modified De vega annuloplasty tech- nique is superior to that of traditional De vega annuloplasty technique in patients with functional TR.