植入合适长度的人工腱索在风湿性心脏病二尖瓣置换术中的临床疗效分析

Clinical effect analysis of implanting appropriate length of artificial tendon during mitral valve replacement for rheumatic heart disease

目的探讨在风湿性心脏病二尖瓣置换术(MVR)中植入合适长度的人工腱索的临床疗效。方法回顾性分析2016年7月至2018年7月在南昌大学第二附属医院行MVR的84例风湿性心脏病患者,所有患者术中均植入合适长度的人工腱索,分析术后早期病死率、手术并发症、术后心脏结构变化及左心室功能变化。结果术后早期死亡1例,术后低心排1例,所有患者术后均无心室破裂、人工瓣膜功能障碍及瓣膜周围渗漏等并发症,术后第5天、3个月和1年复查左房内径、左心室舒张末期内径及收缩末期内径均短于术前,左心室射血分数高于术前(P<0.05)。结论风湿性心脏病患者行MVR中植入合适长度的人工腱索能够有效维护左心室功能,减少术后并发症及改善患者术后生活质量。

Objective To investigate the clinical effect of implanting a suitable length of artificial tendon in mitral valve replacement(MVR)of rheumatic heart disease.Methods A retrospective analysis of 84 patients with rheumatic heart disease who underwent MVR at the Second Affiliated Hospital of Nanchang University from July 2016 to July 2018 was performed.Implanting appropriate length of artficial tendo was performed in all patients.Mortality,postoperative complications,postoperative cardiac structural changes,and changes in left ventricular function were analyzed.Results One patient died early in operation and one patient had low cardiac output after operation.All patients had no complications such as ventricular rupture,prosthetic valve dysfunction and peri-valvular leakage.The left atrial diameter,left ventricular end-diastolic diameter and end-systolic diameter at the time of 5th day,3 months and 1 year after operation were shorter than those before surgery,and the left ventricular ejection fraction was higher than that before surgery(P<0.05).Conclusion The implantation of a suitable length of artificial tendon in patients with rheumatic heart disease who undergoing MVR can effectively maintain left ventricular function,reduce postoperative complications and improve postoperative quality of life.