保留后瓣及其瓣下结构二尖瓣置换术对风湿性二尖瓣狭窄患者的影响

The Influence of Rheumatic Mitral Stenosis Patients for Retention Mitral Valve and Under Mitral Valve Structure by Mitral Valve Replacement

目的:探讨保留后瓣及其瓣下结构二尖瓣置换术对风湿性二尖瓣狭窄患者的影响情况。方法:分析我院2016年2月-2018年3月收治的风湿性二尖瓣狭窄患者115例临床资料,依据随机纸片法进行分组,对照组(术中未保留后瓣和瓣下结构)45例和观察组(术中保留后瓣和瓣下结构)70例,观察两组风湿性二尖瓣狭窄患者体外循环时间、ICU滞留时间、呼吸机辅助时间、主动脉阻断时间、住院时间情况,观察两组患者手术前、手术后1个月左室舒张末期内径(LVEDD)、左室短轴缩短率(LVFS)及左室射血分数(LVEF)情况。结果:观察组风湿性二尖瓣狭窄患者ICU滞留时间、呼吸机辅助时间、住院时间均低于对照组,差异均有统计学意义(P<0.05)。两组患者体外循环时间、主动脉阻断时间比较,手术前LVEDD、LVFS及LVEF比较,对照组患者手术后1个月和同组手术前的LVEF比较,差异均无统计学意义(P>0.05),观察组患者手术后1个月LVEF高于同组手术前。手术后1个月两组患者LVEDD、LVFS均高于同组手术前,观察组患者手术后1个月LVEDD低于对照组,LVFS、LVEF高于对照组,差异均有统计学意义(P<0.05)。结论:保留后瓣及其瓣下结构二尖瓣置换术治疗风湿性二尖瓣狭窄,可以明显缩短患者ICU滞留时间、呼吸机辅助时间和住院时间,改善心功能水平,值得临床推广应用。

Objective:To approach influence of rheumatic mitral stenosis patients for retention mitral valve and under mitral valve structure by mitral valve replacement.Methods:The 115 cases clinical data of rheumatic mitral stenosis patients in our hospital from February 2016 to March 2018 were analyzed,which was to be divided into two group by random paper method,control group(no retention mitral valve and under mitral valve structure in operation)45 cases and detection group(retention mitral valve and under mitral valve structure in operation)70 cases,the extracorporeal circulation time,ICU retention time,respiratory assistance time,aortic occlusion time,hospitalization duration of two group rheumatic mitral stenosis patients were detected,LVEDD,LVFS,LVEF of two group patients before operation and after operation 1 month were detected.Results:The ICU retention time,respiratory assistance time,hospitalization duration of detection group rheumatic mitral stenosis patients were lower than control group,the difference were statistical significance(P<0.05).The extracorporeal circulation time,aortic occlusion time of two group patients were compared,the LVEF of control group patients after operation 1 month and before operation in the same group were compared,the difference were no statistical significance(P>0.05),the LVEF of detection group after operation 1 month were higher than before operation in the same group,the LVEDD,LVFS of two group patients after 1 month were higher than before operation in the same group,the LVEDD of detection group patients after operation 1 month were lower than control group,LVFS,LVEF were higher than control group,the difference were statistical significance(P<0.05).Conclusion:The rheumatic mitral stenosis patients for retention mitral valve and under mitral valve structure by mitral valve replacement,which could short ICU retention time,respiratory assistance time,hospitalization duration,improve heart function level,it is worth to be used.