风湿性二尖瓣置换术的危险因素研究进展

Research Progress in Risk Factors of Rheumatic Mitral Valve Replacement

二尖瓣置换术是采用由人工合成材料制成的二尖瓣机械瓣膜或用生物组织制成的二尖瓣生物瓣膜替换原有病变二尖瓣的心脏外科手术。它是治疗风湿性二尖瓣病变的主要方法,随着技术的成熟,二尖瓣置换术病死率明显降低,患者生活质量得到极大改善。目前风湿性二尖瓣置换术已广泛应用于临床。而诸多危险因素,如患者性别、年龄、术前心功能、二尖瓣病变的严重程度、术中人工瓣膜的选择、原有瓣膜结构的保留与否、体外循环以及术后抗凝、人工瓣膜情况等与患者的预后密切相关。如何减少和避免上述危险因素的发生,探索更优化的个体化风湿性二尖瓣病变治疗方案,是目前研究的主要方向。

Mitral valve replacement is a cardiac surgery by artificial mechanical mitral valve made of synthetic material or artificial biological mitral valve made of biological tissue,which is an effective therapy of rheumatic mitral valve disease.It has been widely used in clinical practice with the operative mortality greatly reduced and patients′quality of life considerably improved than before.However,many risk factors such as gender,age,preoperative cardiac function,severity of mitral valve disease,choice of artificial valve,preservation of mitral valve structure,cardiopulmonary bypass,anticoagulation method and prosthetic valve condition are closely associated with the prognosis of the patients.The main research direction is how to reduce and avoid those risk factors to explore a more optimized individual treatment of rheumatic mitral valve disease.