风湿性二尖瓣整体修复术临床效果的单中心回顾性研究

Clinical efficacy of overall repair technique for rheumatic mitral valve lesions:A retrospective study in a single center

目的探讨二尖瓣整体修复术治疗风湿性二尖瓣病变的临床疗效。方法回顾性分析2021—2022年于川北医学院附属医院心脏大血管外科诊断为风湿性二尖瓣病变并在体外循环下行二尖瓣修复术患者的临床资料。结果共纳入100例患者,其中女78例、男22例,平均年龄52岁。整组患者无二次开胸、死亡。体外循环时间(136.3±33.1)min,主动脉阻断时间(107.6±27.5)min,呼吸机使用时间(12.9±5.9)h,ICU停留时间(2.6±1.4)d,血管活性药物使用量(823.4±584.4)mg。患者手术前后,左心室舒张末期前后径、左心房收缩末期前后径、二尖瓣有效瓣口面积、左心室短轴缩短率、二尖瓣E峰血液流速、二尖瓣平均跨瓣压差、二尖瓣压力减半时间、纽约心脏协会心功能分级差异有统计学意义(P<0.05);左心室射血分数、左心室舒张末期容积差异无统计学意义(P>0.05)。结论风湿性二尖瓣病变整体修复术可显著改善患者心功能及血流动力学,是风湿性二尖瓣病变患者的良好选择。

Objective To investigate the clinical efficacy of mitral valve repair technique in the treatment of rheumatic mitral valve lesions.Methods The clinical data of patients diagnosed with rheumatic mitral valve lesions and undergoing mitral valve repair under extracorporeal circulation in our department from 2021 to 2022 were retrospectively analyzed.Results A total of 100 patients were collected,including 78 females and 22 males with an average age of 52 years.There were no secondary open heart or death in the whole group.Extracorporeal circulation time was 136.3±33.1 min,aortic cross-clamping time was 107.6±27.5 min,ventilator use time was 12.9±5.9 h,ICU stay was 2.6±1.4 d,and vasoactive medication use was 823.4±584.4 mg.Before and after the surgery,there were statistical differences in the left ventricular end diastolic diameter,left atrial end systolic diameter,effective mitral valve orifice area,shortening rate of left ventricular short axis,mitral E-peak blood flow velocity,mean mitral transvalvular pressure difference,mitral pressure half-time,and cardiac function graded by New York Heart Association(P<0.05).While there was no statistical difference in left ventricular ejection fraction or left ventricular end-diastolic volume(P>0.05).Conclusion Overall repair of rheumatic mitral valve lesions can significantly improve the cardiac function and hemodynamics of the patients,and is a good choice for patients with rheumatic mitral valve lesions.