经皮球囊扩张术治疗27例二尖瓣再狭窄效果研究

STUDY ON CLINICAL EFFECTS OF THE PERCUTANEOUS TRANSVENOUS MITRAL COMMISSUROTOMY OF TWENTYSEVEN PATIENTS WITH MITRAL RESTENOSIS

目的：探讨经皮球囊扩张术治疗二尖瓣再狭窄的临床效果。方法：对１９例闭式扩张术后二尖瓣再狭窄（ＭＲＳ）和经皮二尖瓣球囊扩张术（ＰＴＭＣ）后ＭＲＳ患者再次施行ＰＴＭＣ。结果：两组二尖瓣口面积（ＭＶＡ）分别增加７１％和７８％。闭式扩张术后经再次ＰＴＭＣ，ＭＶＡ从（１．３５±０．３４）ｃｍ２提高到（２．３１±０．３２）ｃｍ２，左房压（ＬＡＰ）由（２．３１±１．１０）ｋＰａ降到（１．２７±０．８７）ｋＰａ，二尖瓣跨瓣压差（ＭＰＧ），从（１．６４±０．６１）ｋＰａ降到（０．６２±０．３９）ｋＰａ。ＰＴＭＣ后ＭＲＳ组，再次ＰＴＭＣ：ＭＶＡ从（１．２５±０．２４）ｃｍ２提高到（２．２３±０．４２）ｃｍ２，ＬＡＰ由（３．３０±０．６１）ｋＰａ降到（１．２６±０．３６）ｋＰａ，ＭＰＧ由（１．８４±０．７３）ｋＰａ降到（０．５９±０．２０）ｋＰａ。结论：再次ＰＴＭＣ与首次ＰＴＭＣ效果相同。

Objective: To study the clinic effect of the percutaneous transvenous mitral commissurotomy in patients with mitral Restenosis Methods: Nineteen mitral restenosis patients after closed mitral commissurotomy and eight after percutaneous transvenous mitral commissurotomy (PTMC) received PTMC againTheir mitral valve area (MVA) increases to 71% and 78%In mitral restenosis group that has been treated with commissurotomy mitral stenosis,MVA increases from (135034)cm2 to (231032)cm2Left atrium pressure (LAP) decreases from (231110)kPa to (127078)kPa,mitral pressure grade (MPG) decreases from (164061)kPa to (062039)kPa,and the group receiving PTMC again after PTMC mitral restenosis also gets good result:MVA increases from (125024)cm2 to (233042)cm2;LAP decreases from (330061)kPa to (126036)kPa;MPG decreases from (184073)kPa to (059020)kPaIt proves that receiving PTMC again has a good effects on the mitral restenosis patients after PTMC,and its clinic result is the same as that of the first PTMC\=