本文選題：肥厚型梗阻性心肌病 + 二尖瓣反流�。� 參考：《上海交通大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)》2017年03期

【摘要】：目的·評(píng)價(jià)RPR技術(shù)治療復(fù)雜肥厚型梗阻性心肌病(HOCM)的臨床療效。方法·2009年6月至2015年12月,采用RPR技術(shù)治療復(fù)雜HOCM 9例。其中男性6例,女性3例;年齡22~63歲,平均(43±19)歲。術(shù)前經(jīng)胸超聲心動(dòng)圖(TTE)均可見(jiàn)二尖瓣收縮期前向運(yùn)動(dòng)(SAM),伴有中度或中度以上的二尖瓣反流(MR)。術(shù)中經(jīng)食管超聲心動(dòng)圖(TEE)評(píng)估手術(shù)效果,術(shù)后1周內(nèi)及隨訪時(shí)TTE復(fù)查手術(shù)效果。結(jié)果·9例患者均治愈出院。術(shù)中TEE證實(shí)RPR術(shù)后左心室流出道壓差(LVOTPG)為(9±3)mm Hg,顯著低于RPR術(shù)操作前[(92±14)mm Hg](P0.01),SAM征全部消失。術(shù)后1周內(nèi)TTE顯示室間隔厚度、LVOTPG、MR明顯好轉(zhuǎn)(P0.01)。術(shù)后平均隨訪26個(gè)月,所有患者癥狀明顯減輕,LVOTPG仍處于較低水平,無(wú)明顯MR,無(wú)死亡,無(wú)再次手術(shù)及其他并發(fā)癥。結(jié)論·RPR技術(shù)可有效解除復(fù)雜HOCM的左心室流出道梗阻及MR,提高患者生活質(zhì)量。
[Abstract]:Objective to evaluate the clinical efficacy of RPR in the treatment of complicated hypertrophic obstructive cardiomyopathy (HOCM). Methods from June 2009 to December 2015, 9 patients with complicated HOCM were treated with RPR technique. There were 6 males and 3 females, aged 2263 years with an average age of 43 鹵19 years. Preoperative transthoracic echocardiography (TTE) showed mitral regurgitation (MRV) with moderate or more moderate mitral regurgitation. Intraoperative transesophageal echocardiography (TEE) was used to evaluate the operative effect, and TTE was performed within 1 week after operation and at follow-up. Results all 9 cases were cured and discharged. Tee confirmed that the left ventricular outflow tract pressure difference (LVOTPG) was 9 鹵3)mm Hg after RPR, which was significantly lower than that before RPR operation [92 鹵14)mm Hg] P0.01 / SAM sign disappeared. Within 1 week after operation, the thickness of interventricular septum and Mr of LVOTP GV were obviously improved by TTE. After an average follow-up of 26 months, the symptoms of LVOTPG in all patients were still at a lower level, with no MRR, no death, no reoperation and other complications. Conclusion RPR technique can effectively relieve left ventricular outflow tract obstruction and MRs in patients with complicated HOCM and improve their quality of life.
【作者單位】： 上海交通大學(xué)醫(yī)學(xué)院附屬瑞金醫(yī)院心臟外科;
【基金】：國(guó)家自然科學(xué)基金(81200093)~~
【分類(lèi)號(hào)】：R654.2

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