二尖瓣成形术的手术临床运用疗效分析

目的通过对行手术治疗的二尖瓣关闭不全的患者进行临床分析,探讨二尖瓣成形术在心脏患者手术中的临床疗效。方法回顾性分析2016年1-2019年1月在昆明医科大学附属曲靖市第一人民医院因"二尖瓣关闭不全"住院的患者,以行二尖瓣手术的患者为研究对象,其中行二尖瓣置换术的患者设为对照组,男性23例,女性15例,年龄40~65岁,平均年龄(53.71±10.67)岁。行二尖瓣成形术的患者设为实验组,男性15例,女性8例,年龄39~63岁,平均年龄(53.21±6.63)岁。术中记录阻断时间、辅助循环时间、食道超声测量术后返流量等数据。术后一周左右复查心脏超声、胸片,观察手术前后左心房、左心室舒张末期内径大小及EF值变化,术后并发症、恢复时间等情况,另通过门诊复查随访等观察,评价手术效果。测定结果采用多样本t检验、χ~2检验。结果实验组体外循环时间、阻断时间、术后出院时间、ICU住院时间均明显优于对照组,且差异具有统计学意义(P<0.05),两组围手术期并发症、二次转机、死亡、术后中度以上返流患者例数差异均无统计学意义(P>0.05)。结论二尖瓣成形术与二尖瓣置换术手术效果相当,且可以很好的缩短体外循环和阻断时间、缩短ICU住院时间,从长期的手术效果看,尚需观察随访。

Analysis of the Clinical Application Effect of Mitral Annuloplasty

Objective To investigate the clinical efficacy of mitral angioplasty in patients with heart disease through clinical analysis of patients with mitral insufficiency who undergo surgical treatment. Methods A retrospective analysis of patients admitted to the First People’s Hospital of Qujing City, Kunming Medical University from January 2016 to January 2019 due to "mitral valve insufficiency". Patients who underwent mitral valve surgery were taken as the research object. Patients undergoing mitral valve replacement were set as the control group, with 23 males and 15 females, aged 40 to 65 years, with an average age of(53.71±10.67) years. The patients who underwent mitral angioplasty were included in the experimental group, with 15 males and 8 females, aged 39 to 63 years, with an average age of(53.21±6.63) years. The occlusion time, auxiliary circulation time, and esophageal echometry were measured during the operation. Cardiac ultrasound and chest X-ray were reviewed about one week after the operation, and changes in the diameter and EF of the left atrium and left ventricle during the end-diastole period, postoperative complications, recovery time, and other conditions were observed. The follow-up observations in the outpatient clinic were performed to evaluate the effect of the operation. Multi-sample t-test and chi-square test were used for the measurement results. Results The time of cardiopulmonary bypass,block time, postoperative discharge time and ICU hospitalization time in the experimental group were significantly better than those in the control group, and the difference was statistically significant(P < 0.05). There was no statistical significance in the number of perioperative complications, secondary transfer, death and postoperative moderate or above reflux patients in the two groups(P > 0.05). Conclusion Mitral valve angioplasty is equivalent to mitral valve replacement surgery, and it can shorten the extracorporeal circulation and occlusion time, and shorten the ICU hospital stay. From the long-term research results, follow-up observation is needed.