二尖瓣置换术中后瓣完全保留或部分保留对左室功能的影响

Effect of complete or partial retention of posterior valve on left ventricular function in mitral valve replacement

目的对比二尖瓣置换术中后瓣完全保留或部分保留对左室功能的影响。方法回顾性分析我院90例行二尖瓣置换术的慢性风湿性心瓣膜病患者的临床资料,其中完全保留后瓣的有50例,记为甲组;部分保留后瓣的有40例,记为乙组。对比两组手术前、后左室形态学指标和左室收缩功能。结果手术后,两组的LVEDD、LVESD、LVPWT及LVL均减小,且甲组明显小于乙组,差异具有统计学意义(P<0.05)。手术后,两组的LVEF和LVFS均升高,且甲组明显高于乙组,差异具有统计学意义(P<0.05)。结论相较于二尖瓣置换术中后瓣部分保留,后瓣完全保留在改善患者左室形态与收缩功能上具有明显优势。

Objective To compare the effects of complete or partial retention of posterior valve on left ventricular function in mitral valve replacement. Methods The clinical data of 90 patients with chronic rheumatic valvular heart disease who underwent mitral valve replacement in our hospital were retrospectively analyzed. Fifty patients with complete retention of posterior valve were recorded as group A, 40 patients with partial retention of posterior valve were recorded as group B. The left ventricular morphology and left ventricular systolic function of both groups before and after surgery were compared. Results After surgery, the LVEDD, LVESD, LVPWT and LVL decreased in both groups, and those of the group A were significantly smaller than the group B, the differences were statistically significant（P〈0.05）. After the operation, the LVEF and LVFS in both groups increased, those of the group A were significantly higher than the group B, the differences were statistically significant（P〈0.05）. Conclusion Compared with the partial retention of posterior valve in mitral valve replacement, the complete retention of posterior valve retains its superiority in improving left ventricular morphology and systolic function.