如何提高退行性二尖瓣病变二尖瓣成形术的疗效

How to improve the effect of mitral valvuloplasty on degenerative mitral valve disease

随着经济的发展及人口老龄化进程加快,老年性疾病发病率有上升趋势。退行性二尖瓣反流是西方国家最常见的瓣膜病,在中国也在不断发展。退行性二尖瓣病变将逐步成为我国二尖瓣病变的首要原因,而二尖瓣成形术(也称瓣膜修复术)是治疗退行性二尖瓣关闭不全的首选方法。如何借鉴国外经验,结合我国特点,建立适合我国的诊疗策略,是提高我国二尖瓣病变诊治水平的关键。本文从提高退行性二尖瓣病变术前诊断准确率、分层评估筛选患者与建立转诊治疗体系、制定精准成形策略与提高成形成功率和远期效果等多个方面结合相关研究成果进行简要论述,以期在保障成像效果的基础上扭转临床医师及患者瓣膜置换的惯性思维,促进二尖瓣成形术的广泛应用。

With the development of economy and the acceleration of population aging process,the incidence of senile diseases has an upward trend.Degenerative mitral regurgitation is the most common valvular disease in the West and is growing in China.Degenerative mitral valve disease will gradually become the primary cause of mitral valve disease in China,and mitral valvuloplasty(valve repair)is the first choice for the treatment of degenerative mitral insufficiency.It is the key to improve the diagnosis and treatment of mitral valve disease in China on how to learn from foreign experience and combine the characteristics of our country to establish a diagnosis and treatment strategy suitable for our country.This paper briefly discusses from the aspects of improving the accuracy of preoperative diagnosis of degenerative mitral valve disease,hierarchical evaluation and screening of patients and the establishment of referral treatment system,formulating accurate shaping strategy and improving the success rate and long-term effect of shaping,with a view to reversing the inertial thinking of clinicians and patients on valve replacement on the basis of ensuring the imaging effect,and promoting the wide application of mitral valve plasty.