心室壁瘤切除左心室成形术治疗冠状动脉正常心室壁瘤患者的临床效果

Outcomes of resection of ventricular aneurysm and left ventricular angioplasty in patients with normal coronary artery

目的观察心室壁瘤切除左心室成形术治疗冠状动脉正常心室壁瘤患者的临床疗效。方法收集2008年1月至2011年5月北京安贞医院心脏外科行心室壁瘤切除左心室成形术的冠状动脉正常心室壁瘤患者共14例，所有患者均有心前区疼痛不适，伴心悸、气促和胸闷等，活动后加重。观察患者手术前后的左心室射血分数和左心室舒张末内径。结果14例患者手术后均痊愈出院，术前与术后左心室射血分数分别为（37±9）％与（50±8）％，术前与术后比较，差异有统计学意义（P〈0．05）；术前和术后的左心室舒张末内径大小分别为（62±10）mm与（53±6）mm，术前术后左心室舒张末内径指标比较，差异有统计学意义（P〈0．05）。14例患者治疗效果良好，心功能均达Ⅰ～Ⅱ级，随访2～12个月。结论通过心室壁瘤切除左心室成形术治疗，患者恢复顺利，没有心脏手术并发症的发生，可以明显改善左心室的功能，这种心脏手术是安全可行的。

Objective To evaluate the clinical curative effect in the patients who underwent resection of ventricular aneurysm and left ventricular angioplasty with normal coronary artery. Methods Totally 14 cases who underwent resection of ventricular aneurysm and left ventrieular angioplasty from January 2008 to May 2011 in Beijing Anzhen Hospital were analyzed. All patients had the symptoms of precordial pain and discomfort, palpitations, shortness of breath, chest tightness and aggravating after associated activities. The left ventricular ejection fraction and left ventricular end diastolic diameter of the patients before and after the operation were observed. Results All the 14 patients fully recovered after operation and were discharged from hospital. There were significant differences in the clinic characteristic between injection fraction （37 ± 9）% and （50 ± 8 ）% （P 〈 0.05 ） and left ventricular end diastolic dimension（ 62 ± 10）mm and （53 ± 6 ）ram（ P 〈 0.05 ）. Fourteen patients were followed up from 2 months to 12 months. All patients had good results. The cardiac function was Ⅰ-Ⅱ grades. Conclusions Through the ventricular aneurysm resection and left ventrieular angioplasty treatment, the patients can recover well. The shortterm curative effect is good.