经皮球囊扩张术治疗风湿性二尖瓣狭窄的临床疗效

目的评价经皮球囊扩张术(PBMV)治疗风湿性二尖瓣狭窄的临床疗效.方法82例风湿性二尖瓣狭窄患者行胸前超声心动图(TTE)检查,对二尖瓣病变行Wilkin法评分(16分制),合并心房纤颤(AF)患者,再行食道超声心动图(TEE)检查,评分≤11分入选.手术采用改良Inove法,术前、后48～72 h分别测定二尖瓣口面积(MVA)、二尖瓣口跨瓣压差(MVPG)、左房内径(LAD)、二尖瓣返流(MR),术中测左房压力(LAP).AF者术后口服乙胺碘呋酮基础上电复律.结果术后MLAP及MVPG均较术前显著降低(P均＜0.01),MVA较术前明显增加(P＜0.01).而LAD在手术前后无显著变化(WT5"BX P).结论PBMV是治疗风湿性二尖瓣狭窄有效而可靠方法.

Clinical effect of percutaneous ballon mitral valvceloplasty in patients with rheumatic mitral stenosis

Objective To evaluate the clinical effect of percutaneous balloon mitral valvuloplasty (PBMV) in treating rheumatic mitral stenosis (MS).Methods 82 MS patients were checked with transthoracic echocardiograpay (TTE) and their mitral valves were scored with Wilkin's methods (16 scores system)and transesophagoeds echocardiography (TEE) were used to patients with atrial fibrillation (AF).Patients with less than and equal to l l scores were selected. PBMV were took with improved Inove's metheod. Mitral valve area(MVA),mitral valve pressure gradient (MVPG),left atrial diameter(LAD) and mitral rigurgitation (MR)were measured before and 24～72 hours after PBMV,left atrial pressure was measured during PBMV.Partial AF patients were given electrical defibrillation after PBMV basing on taking aminodarone.Results Both LAP and MVPG were slightly decreased, and MVA valves were significantly increased comparied with those before PBMV(P<0.01).But there were no significant difference in LAD values before and after PBMV(P>0.05).Conclusion PBMV is an effective and reliable technical method in treating rheumatic MS.