本文選題：二尖瓣狹窄 + 二尖瓣關(guān)閉不全��； 參考：《昆明醫(yī)科大學(xué)》2016年碩士論文

【摘要】：[目的]總結(jié)在我院行單純二尖瓣置換術(shù)(MVR)的58例二尖瓣狹窄(MS)或二尖瓣關(guān)閉不全(MI)患者術(shù)前、術(shù)后及遠期隨訪時左心室結(jié)構(gòu)的相關(guān)超聲心動圖數(shù)據(jù),比較MVR術(shù)后MS與MI患者左心室重構(gòu)過程,并總結(jié)相關(guān)臨床治療經(jīng)驗。[方法]選擇2002年8月-2015年8月在昆明醫(yī)科大學(xué)第二附屬醫(yī)院胸心外科住院行MVR術(shù)的54例二尖瓣疾病(MS或MI)患者作為研究對象。根據(jù)其主要病變分為二尖瓣狹窄組(A組)和二尖瓣關(guān)閉不全組(B組),分別收集患者術(shù)前1周、術(shù)后1-2周及術(shù)后隨訪時LVD、LVEF數(shù)據(jù),采用配對樣本t檢驗比較患者術(shù)前、術(shù)后及遠期的左心室內(nèi)徑和左心室射血分數(shù)。[結(jié)果]所有患者均順利手術(shù)并出院。二尖瓣狹窄組(A組)患者的術(shù)后近期LVD(42.76±5.50mm)與術(shù)前(43.63±5.55mm)相比無顯著變化(P0.05)；術(shù)后近期LVEF(62.19%±7.05%)與術(shù)前LVEF(61.58%±6.51%)相比無顯著差異(P0.05)。遠期隨訪數(shù)據(jù)顯示本組遠期LVD(47.47±3.31mm)較術(shù)前增加,遠期LVEF(66.22%±4.4%)較術(shù)前有顯著提高(P0.05)。二尖瓣關(guān)閉不全組(B組)患者術(shù)后LVD(51.29±7.56mm)與術(shù)前(58.21±9.09mm)相比顯著降低(P0.05),而術(shù)后LVEF(59.08%±7.42%)較術(shù)前(61.25%±8.37%)無顯著變化(P0.05)。遠期隨訪數(shù)據(jù)顯示本組LVD(47.25±5.05mm,P0.05))較術(shù)前有顯著減小,遠期隨訪LVEF(61.92%±3.75%,P0.05)與術(shù)前相比無顯著變化,但與術(shù)后近期LVEF相比較有顯著提高(P0.05)。[結(jié)論]1二尖瓣狹窄為主要病變的患者MVR術(shù)后近期左心室內(nèi)徑和射血分數(shù)與術(shù)前保持同一水平。術(shù)后遠期左心室較術(shù)前增大,左室射血功能較術(shù)前明顯增強。2二尖瓣關(guān)閉不全為主要病變的患者MVR術(shù)后近期左心室內(nèi)徑較術(shù)前減小,左室射血分數(shù)與術(shù)前保持同一水平。術(shù)后遠期左心室進一步減小,左室射血分數(shù)與術(shù)前保持同一水平但較術(shù)后近期有所提高。3二尖瓣狹窄為主要病變的患者MVR術(shù)后左心室重構(gòu)在遠期較明顯,二尖瓣關(guān)閉不全為主要病變的患者MVR術(shù)后左心室構(gòu)型即有明顯改變,且術(shù)后遠期其左心室有進一步重構(gòu)的過程。
[Abstract]:[objective] to summarize the echocardiographic data of left ventricular structure in 58 patients with mitral stenosis (MS) or mitral insufficiency (MIM) who underwent simple mitral valve replacement in our hospital. To compare the left ventricular remodeling process between MS and MI patients after MVR, and summarize the clinical experience. [methods] from August 2002 to August 2015, 54 patients with mitral valve disease (MS or MVR) who were hospitalized in thoracic and cardiac surgery, second affiliated Hospital of Kunming Medical University, were selected as the study objects. The patients were divided into mitral stenosis group (group A) and mitral valve insufficiency group (group B) according to their main lesions. LVDN LVEF data were collected 1 week before operation, 1-2 weeks after operation and follow-up after operation. Postoperative and long term left ventricular diameter and left ventricular ejection fraction. [results] all patients were successfully operated and discharged. There was no significant difference in the postoperative LVD(42.76 鹵5.50mm between the patients with mitral stenosis (43.63 鹵5.55mm) and the patients with mitral stenosis (62.19% 鹵7.05mm), and there was no significant difference between the patients with postoperative LVEFV (61.58% 鹵6.51mm) and the patients with preoperative LVEFV (61.58% 鹵6.51mm). Long-term follow-up data showed that the long-term LVD(47.47 鹵3.31mm in this group was higher than that before operation, and the long-term LVEF was 66.22% 鹵4.4mm, which was significantly higher than that before operation (P 0.05). The postoperative LVD(51.29 鹵7.56 mm of mitral valve insufficiency group (LVD(51.29 鹵7.56 mm) was significantly lower than that of preoperation (58.21 鹵9.09 mm), but the postoperative LVEFV 59.08% 鹵7.42%) had no significant change compared with that of preoperation (61.25% 鹵8.37 mm). Long-term follow-up data showed that the LVD(47.25 鹵5.05 mm P0.05) was significantly lower than that before operation. The long-term follow-up showed that there was no significant change in LVEF (61.92% 鹵3.75mm P0.05) compared with pre-operation, but there was a significant increase in LVEF compared with that before operation (P 0.05). [conclusion] 1 the left ventricular diameter and ejection fraction in patients with mitral stenosis were the same as those before MVR. The left ventricular ejection function and left ventricular ejection function in patients with mitral insufficiency were significantly increased in the long term after MVR. 2. The left ventricular internal diameter was decreased in the short term after MVR, and the left ventricular ejection fraction remained the same level as before operation. After MVR, left ventricular remodeling was more obvious in patients whose left ventricular ejection fraction (LVEF) remained at the same level as before operation, but increased by 3. 3 mitral stenosis as the main lesion after MVR. The left ventricular configuration of patients with mitral insufficiency was significantly changed after MVR, and the process of left ventricular remodeling occurred in the long term after MVR.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R654.2

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本文編號：1841965