风湿性二尖瓣病变行二尖瓣成形术的效果分析

目的 探讨风湿性二尖瓣病变行二尖瓣成形术的临床效果。 方法 选取2016年1月至2020年1月在郑州大学第一附属医院心外科因风湿性二尖瓣病变治疗的133例患者为研究对象。其中46例患者行二尖瓣成形术（观察组），87例患者行二尖瓣置换术（对照组）。观察组中男性10例，女性36例，平均年龄（53.80±8.87）岁；对照组中男性25例，女性62例，平均年龄（56.54±9.88）岁。收集两组患者的基线资料、术前超声结果、围手术期资料、随访资料（术后6个月），分析二尖瓣成形术的临床效果。 结果 观察组的主动脉阻断时间、体外循环时间、住院时间与对照组相比，差异无统计学意义（P > 0.05）。观察组术后呼吸机辅助时间较对照组短（9.4±1.6）h比（12.9±1.5）h]，差异有统计学意义（P < 0.05）。观察组与对照组术后 6个月左房内径（41.00±8.00）mm比（46.75±10.13）mm]、左室舒张末期内径（45.49±5.90）mm比（47.87±5.66）mm]差异有统计学意义，且观察组小于对照组（P < 0.05）。 结论 二尖瓣成形术治疗风湿性二尖瓣病变的早期临床效果满意，有利于心脏重构，值得临床推广应用。

The curative effect of mitral valve repair on rheumatic mitral lesions

Objective To investigate the clinical outcomes of mitral valve repair for rheumatic mitral lesions. Methods A total of 133 patients with rheumatic mitral valve disease treated in the Department of Cardiovascular Surgery in the First Affiliated Hospital of Zhengzhou University from January 2016 to January 2020 were selected as the study subjects. Mitral valve repair was performed in 46 patients (observation group) and mitral valve replacement in 87 patients (control group). There were 10 males and 36 females in the observation group, with an average age of (53.80±8.87) years. There were 25 males and 62 females in the control group, with an average age of (56.54±9.88) years. Baseline data, preoperative echocardiography results, perioperative data and follow-up data (6 months after surgery) of patients in the two groups were collected to analyze the clinical outcomes of mitral valve repair. Results There were no significant differences in aortic cross-clamp time, cardiopulmonary bypass time and hospital stay between the observation group and the control group (P<0.05). The time of postoperative ventilator assistance in the observation group was lower than that in the control group (9.4±1.6) h vs. (12.9±1.5) h], and the difference was statistically significant (P<0.05). There were significant differences in left atrial diameter (41.00±8.00) mm vs. (46.75±10.13) mm] and left ventricular end-diastolic diameter (45.49±5.90) mm vs. (47.87±5.66) mm] between the observation group and the control group 6 months after surgery, and the observation group smaller than those of the control group (P<0.05). Conclusion The early curative effect of mitral valve repair on rheumatic mitral lesions is satisfactory, which is beneficial to cardiac remodeling and worthy of clinical application.