【摘要】：目的總結(jié)主動(dòng)脈環(huán)上瓣在成人小主動(dòng)脈瓣環(huán)患者瓣膜置換術(shù)中的臨床應(yīng)用,提高手術(shù)效果。方法選擇2008年11月-2016年3月間62例小主動(dòng)脈瓣環(huán)患者行環(huán)上瓣(ATS.AP)置換術(shù)及62例非小主動(dòng)脈瓣環(huán)患者行常規(guī)機(jī)械瓣置換術(shù),兩組患者分別于術(shù)前、術(shù)后1周行超聲心動(dòng)圖檢查,檢測(cè)并計(jì)算患者有效瓣口面積指數(shù)(EOAI)、左室射血分?jǐn)?shù)(LVEF)、左室短軸縮短率(LVFS)、主動(dòng)脈瓣峰值跨瓣壓差(TAVPPG)、左室舒末徑(LVEDD),觀察兩組患者術(shù)后人工瓣膜與體表面積不相匹配現(xiàn)象(PPM)發(fā)生率,評(píng)價(jià)手術(shù)效果。結(jié)果術(shù)后1周與術(shù)前相比較,復(fù)查超聲心動(dòng)圖測(cè)得兩組患者主動(dòng)脈瓣峰值跨瓣壓差(TAVPPG)明顯下降(P均0.05),左室射血分?jǐn)?shù)(LVEF)提高(P均0.05),左室短軸縮短率(LVFS)提高(P均0.05),左室舒末徑(LVEDD)明顯下降(P均0.05),有效瓣口面積指數(shù)(EOAI)明顯提高(P均0.05),差異均有統(tǒng)計(jì)學(xué)意義。環(huán)上瓣(ATS.AP瓣)置換組與常規(guī)機(jī)械瓣置換組術(shù)前、術(shù)后1周上述指標(biāo)改善差值相比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P均0.05)。結(jié)論小主動(dòng)脈瓣環(huán)患者行環(huán)上瓣(ATS瓣)置換術(shù)與非小主動(dòng)脈瓣換患者行常規(guī)機(jī)械瓣置換術(shù),術(shù)后復(fù)查超聲心動(dòng)圖各項(xiàng)指標(biāo)均得到改善,均可獲得良好的血流動(dòng)力學(xué)效果。環(huán)上瓣(ATS.AP瓣)組術(shù)后無(wú)人工瓣膜與體表面積不匹配(PPM)現(xiàn)象發(fā)生,左心功能各項(xiàng)指標(biāo)及血流動(dòng)力學(xué)改善與正常主動(dòng)脈瓣環(huán)瓣膜置換患者無(wú)差異。
[Abstract]:Objective to summarize the clinical application of superior aortic annulus valve in adult patients with small aortic annulus. Methods from November 2008 to March 2016, 62 patients with small aortic annulus underwent superior annular valve replacement (ATS.AP) and 62 patients with non-small aortic annulus underwent routine mechanical valve replacement. One week after operation, echocardiography was performed to detect and calculate the effective valve area index (EOAI), left ventricular ejection fraction (LVEF), left ventricular short-axis shortening rate (LVFS), peak aortic valve pressure difference (TAVPPG), left ventricular diastolic diameter (LVEDD),). The incidence of (PPM) mismatch between prosthetic valve and body surface area was observed and the effect of operation was evaluated. Results at 1 week after operation, (TAVPPG) of peak transvalvular pressure difference of aortic valve was significantly decreased and left ventricular ejection fraction (LVEF) was increased in both groups as compared with that before operation by reexamination echocardiography (P0. 05), and the left ventricular ejection fraction (LVEF) was significantly increased in both groups (P < 0. 05). The shortening rate of short axis of left ventricle (LVFS) was increased (P 0.05), the (LVEDD) of left ventricular diastolic diameter was significantly decreased (P 0.05), and the effective valve area index (EOAI) was significantly increased (P 0.05). There was no significant difference between the superior annular valve (ATS.AP) replacement group and the conventional mechanical valve replacement group before and 1 week after operation (P < 0. 05). Conclusion Superior annular valve replacement (ATS) and conventional mechanical valve replacement are performed in patients with small aortic annulus. There was no mismatch between prosthetic valve and body surface area (PPM) in the group of superior annular valve (ATS.AP), and there was no difference in the indexes of left ventricular function and hemodynamics between the patients with normal aortic annular valve replacement and that of the patients with normal aortic annular valve replacement.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R654.2
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本文編號(hào)：2397684