全软成形环与缘对缘瓣膜成形术在心脏瓣膜关闭不全成形术中的疗效比较

Comparison of curative effect between totally flexible prosthetic ring operation and edge to edge valvuloplasty on cardiac valvular regurgitation forming technique

目的:比较全软成形环与缘对缘瓣膜成形术在心脏瓣膜关闭不全成形术中的疗效。方法:选取我院心外科收治的二尖瓣关闭不全患者90例,随机分为两组,其中A组45例,予全软成形环术治疗;B组45例,予缘对缘瓣膜成形术治疗,术后均给予维持心输出量、抗凝常规治疗,手术前后对比两组患者二尖瓣形态、心搏出量、射血速率、射血时间及临床疗效。结果:(1)手术后两组二尖瓣形态及左心室内径均有所改善,与B组比较,A组二尖瓣口面积明显增大,二尖瓣环的面积、收缩期及舒张期二尖瓣环周径、左心室内径明显减小,差异有统计学意义(P<0.05);(2)手术后两组心搏出量、射血速率、射血时间均有所改善,与B组比较,A组心搏出量和射血速率明显增大,射血时间明显缩短,差异有统计学意义(P<0.05);(3)手术后A组总有效率(95.56%)明显高于B组(88.89%),差异有统计学意义(P<0.05)。结论:与缘对缘瓣膜成形术相比,全软成形环术在心脏瓣膜关闭不全成形术中的疗效更佳,对临床具有指导意义,值得临床推广。

Objective：To compare curative effect between totally flexible prosthetic ring and edge to edge valvuloplasty in valvular regurgitation forming technique.Methods：A total of 90 patients with heart surgery were selected,and randomly divided into two groups,including 45 cases of A group with totally flexible prosthetic ring treatment and 45 cases in group B treated with edge to edge valve plasty.Before and after the operation,mitral valve morphology,stroke volume,ejection rate,ejection time and clinical effect were compared.Results：In two groups after operation,mitral valve morphology and left ventricular internal classics are improved.Compared with group B,mitral valve area of group A was increased significantly,the mitral annulus systolic area and diastolic mitral annular circumference,left ventricular diameter were decreased significantly（P 〈 0.05）.After operation stroke volume,ejection rate,ejection time were improved.Compared with group B,stroke volume and ejection rate were increased significantly,ejection time was shortened significantly in group A（P〈 0.05）.After the operation,the total effective rate of the A group（95.56%）was significantly higher than that of B group（88.89%）（P 〈0.05）.Conclusions：Totally flexible prosthetic ring has better curative effect in the treatment of valvular regurgitation forming.It is worthy clinical promotion.