| 刘日辉,赵华,陈家军.涤纶对折条在三尖瓣环成形术中的应用[J].安徽医药,2016,20(1):78-81. |
| 涤纶对折条在三尖瓣环成形术中的应用 |
| Application of terylene folded strip in tricuspid valve annuloplasty |
| 投稿时间：2015-07-21 |
| DOI： |
| 中文关键词: 三尖瓣反流 三尖瓣环成形术 |
| 英文关键词: tricuspid valve regurgitation tricuspid valve annuloplasty |
| 基金项目: |
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| 中文摘要: |
| 目的 总结涤纶对折条在三尖瓣环成形术中的应用效果。方法 回顾分析2010年1月至2012年1月该院收治功能性三尖瓣关闭不全(FTR)74例临床资料,行瓣膜置换或先心病矫治同期三尖瓣成形术。按成形方法不同分为两组:De Vega成形组(组1)32例,其中三尖瓣轻度反流12例,中度反流18例,重度反流2例；涤纶对折条成形组(组2)40例,其中三尖瓣轻度反流12例,中度反流17例,重度反流11例。比较两组患者术前、术后第1年、术后第3年临床及心脏超声随访资料。结果 术后早期死亡2例,1例死于恶性心律失常、心博骤停(组1),1例死于严重低心排、肾功能衰竭(组2),余两组患者均痊愈出院。72例患者完成1年门诊随访。68例患者(94.9%)完成3年或以上随访。随访期间左心房血栓形成3例,无右心血栓事件发生。华法林抗凝同时加服拜阿司匹林100 mg 3~6月后,左心房血栓消失。术后1年、3年随访,两组间残存三尖瓣反流程度比较,差异具有明显统计学意义(P<0.01)。随访超声资料右心功能指标:舒张期右心房内径(RA)、右心室内径(RV)和三尖瓣环内径(DTv),测量收缩期三尖瓣反流束的最大面积(Sm)及右心房的面积(SRA),术后第1年两组RA、RV、Sm/SRA、DTv与术前比较,差异均具有明显统计学意义(P<0.01)。术后第3年,组1与术前比较Sm/SRA差异无统计学意义(P>0.05),RA、RV、DTv差异有统计学意义(P<0.01)；组2 RA、RV、Sm/SRA、DTv与术前比较,差异均具有明显统计学意义(P<0.01)。两组间术后第1年RA、RV比较,差异无统计学意义(P>0.05),组2 Sm/SRA、DTv低于组1(P<0.01)；术后第3年,两组间RA、RV、Sm/SRA、DTv比较,差异均有明显统计学意义(P<0.01)。结论 采用涤纶对折条三尖瓣环成形术中远期效果优于De Vega成形术。 |
| 英文摘要: |
| Objective To summarize the application effect of terylene folded strip in tricuspid valve annuloplasty (TVA). Methods Clinical data of 74 cases of functional tricuspid regurgitation (FTR) treated from January 2010 to January 2012 in Hospital Affiliated to Hubei University of Arts and Science were retrospectively analyzed. All patients underwent TVA operation over the same period of heart valve replacement or congenital heart disease orthodontic treatment. According to various forming methods patients were assigned into two groups:De Vega forming group (group 1, n=32), of which tricuspid valve with mild regurgitation in 12 cases, moderate regurgitation in 18 cases, severe reflux in 2 cases, and terylene folded strip forming group (group 2, n=40), of which tricuspid valve with mild regurgitation in 12 cases, moderate regurgitation in 17 cases, severe reflux in 11 cases. Patients were compared between the two groups before operation and the first year, third years after surgery in clinical and echocardiographic follow-up data. Results There were 2 cases of early postoperative death. One case in group 1 died of malignant arrhythmia, cardiac arrest, and 1 case in group 2 died of severe low cardiac, renal failure. The other patients were cured and discharged. 72 patients had 1-year follow-up, and 68 patients (94.9%) had 3 or more years of follow-up. According to the 1-year and 3-year follow-up, tricuspid regurgitation degree between the two groups had obvious statistical difference (P<0.01). RA, RV, Sm/SRA, DTv of the two groups were statistically different from those before surgery(P<0.01). At the third year after surgery, Sm/SRA had no significant difference(P>0.05) while RA, RV, DTv had significant difference (P < 0.01) from preoperation in group 1, but RA, RV, Sm/SRA, DTv of group 2 were statistically different from preoperation(P<0.01). RA, RV between the two groups were not significantly different (P>0.05), and the levels of Sm/SRA, DTv in group 2 were lower than those in group 1 (P<0.01) the first year after surgery. At the third year after surgery, RA, RV, Sm/SRA, DTv between the two groups were significantly different (P<0.01). Conclusion The long-term effect of using terylene foleded strip in TVA intraoperatively is better than De Vega plasty. |
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