风湿性二尖瓣狭窄的瓣膜外科修复研究进展

Research progress of surgical treatment without valve replacement for rheumatic mitral stenosis

风湿性二尖瓣狭窄是我国最常见的心脏瓣膜病之一,欧美国家较为少见。内科保守治疗主要用于处理并发症,无法从根本上改变病变瓣膜结构。外科治疗有二尖瓣闭式瓣膜扩张、经皮腔内二尖瓣球囊成形、二尖瓣直视下修复以及人工瓣膜置换。临床上,针对风湿性二尖瓣狭窄患者所采取的外科治疗方法中,瓣膜置换的比例较大,修复的比例较小。在可行的情况下,瓣膜修复具有更好的远期预后效果。本文通过整理国内外相关文献,对风湿性二尖瓣狭窄患者的瓣膜修复方法进行总结,希望为外科医生提供一定的参考。

Rheumatic mitral stenosis is one of the most common cardiac valvulopathies in our country,which is relatively rare in European and American countries.Medical therapy is reserved mainly for the treatment of complications,which can not fundamentally change the valve structure.Only surgical treatments can correct these valve lesions,including closed mitral commissurotomy,percutaneous balloon mitral valvuloplasty,mitral valve repair under direct vision and mitral valve replacement.Numerous studies demonstrate that valve repair provides better long-term results,though it occupies a low proportion clinically.This article reviewed domestic and foreign literature concerning surgical treatments for patients with rheumatic mitral stenosis to provide some reference for the peers.