彩色超声多普勒检查对二尖瓣闭式扩张术远期疗效的评价

Color echocardiography evaluating long-term effectiveness of closed mitral commissurotomy

回顾性分析47例二尖瓣狭窄患者行闭式扩张手术前后彩色超声多普勒检查及其对手术远期疗效的评估情况。结果发现术后二尖瓣口面积(MVA)、跨瓣压力阶差(MVG)和心排血量(CO)均较术前明显改善(P<0.01);随访38例,5年、10年心功能达Ⅰ～Ⅱ级者分别为87.5％(20/32)和66.7％(16/24)。其中彩超二尖瓣形态积分<8分的患者5年后心功能达Ⅰ～Ⅱ级者为20/20,积分在8～12分者为8/12(P<0.05)。二尖瓣闭式扩张术是一安全、有效、经济易行的术式,在目前条件下,仍应保留其应有的地位。彩色超声多普勒作为一种无创的手段,可以作为确定手术指征和评价疗效的首选方法。

A retrospective review of 47 patients underwent closed mitral commissurotomy(CMC) was conducted. It was revealed that the post-operative color echocardiography indices (MVA ,MVG,CO) were significantly improved compared with those of pre-operation (P<0. 01). Thirty-eight patients were followed-up; 87. 5%(20/32) and 66. 7% (16/24) patients had NYHA class Ⅰ-Ⅱ for 5 and 10 years respectively. Patients with pre-operative echocardiographic morphometry index <8 all had NYHA class Ⅰ-Ⅱ in 5 years and 66. 7% patients with index >8 had NYHA class Ⅰ-Ⅱ in 5 years(P<0. 05). It is indicated that CMC is a safe,effective and economical procedure,and color Doppler echocardiography as a non-invasive inspection should be the best operative indication and be used to evaluate the curative effects.