瓣膜成形环在治疗功能性三尖瓣关闭不全中的疗效分析

目的 分析评价三尖瓣成形环成形术在治疗中、重度三尖瓣功能性关闭不全中的效果.方法 自2008年1月至2010年1月对75例中度至重度功能性三尖瓣反流的患者行三尖瓣成形手术,其中31例采用传统Devega法成形术(对照组)；44例采用国产佰仁思瓣膜成形软环(成形环组),分析对比两组手术方法及成形效果. 结果 75例患者中围手术期死亡4例,死亡率为5.3％,其中69例(97.2％)患者于术后1个月、1年、18个月进行随访,随访末期,对照组与成形环组左室射血分数、肺动脉收缩压差异无明显统计学意义(P＞0.05),而对照组48.1％ (13/27)出现中度以上三尖瓣反流,成形环组16.7％ (7/42)出现中度以上反流,两组间差异有统计学意义(P＜0.01). 结论 三尖瓣成形环在治疗功能性三尖瓣反流方面具有较好的中期效果.

The Clinic Efficacy of Annuloplasty Ring in the Treatment of Functional Tricuspid Regurgitation

Objective To evaluate the efficacy of ring annuloplasty in the treatment of medium to severe functional tricuspid regurgitation.Methods A total of 75 consecutive patients with medium to severe functional tricuspid regurgitation who underwent tricuspid annuloplasty from January 2008 to January 2010 were retrospectively analyzed.The patients were divided into two groups: Devegar procedure group(n=31) and annuloplasty ring group(n=44).Results There were 4 peri-operation deaths with mortality of 5.3%.On 1 month,1 year and 18 months after operation,69 patients(97.2%) completed the follow-up.The follow-up result showed there was no obvious difference between two groups in left ventricular ejection fraction and pulmonary artery systolic pressure(P>0.05).At the end of follow-up,the medium and severe tricuspid regurgitation rate was 48.1%(13/27),which was much greater than 16.7%(7/42) of the annuloplasty ring group(P<0.01).Conclusion Annuloplasty ring is an effective treatment for functional tricuspid regurgitation with better midterm result.