RPR技术治疗复杂肥厚型梗阻性心肌病

发布时间：2018-06-18 11:57

本文选题：肥厚型梗阻性心肌病 + 二尖瓣反流　；参考：《上海交通大学学报(医学版)》2017年03期

【摘要】：目的·评价RPR技术治疗复杂肥厚型梗阻性心肌病(HOCM)的临床疗效。方法·2009年6月至2015年12月,采用RPR技术治疗复杂HOCM 9例。其中男性6例,女性3例;年龄22~63岁,平均(43±19)岁。术前经胸超声心动图(TTE)均可见二尖瓣收缩期前向运动(SAM),伴有中度或中度以上的二尖瓣反流(MR)。术中经食管超声心动图(TEE)评估手术效果,术后1周内及随访时TTE复查手术效果。结果·9例患者均治愈出院。术中TEE证实RPR术后左心室流出道压差(LVOTPG)为(9±3)mm Hg,显著低于RPR术操作前[(92±14)mm Hg](P0.01),SAM征全部消失。术后1周内TTE显示室间隔厚度、LVOTPG、MR明显好转(P0.01)。术后平均随访26个月,所有患者症状明显减轻,LVOTPG仍处于较低水平,无明显MR,无死亡,无再次手术及其他并发症。结论·RPR技术可有效解除复杂HOCM的左心室流出道梗阻及MR,提高患者生活质量。
[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 卤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 卤3)mm Hg after RPR, which was significantly lower than that before RPR operation [92 卤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.
【作者单位】：上海交通大学医学院附属瑞金医院心脏外科;
【基金】：国家自然科学基金(81200093)~~
【分类号】：R654.2

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