成形术对二尖瓣三维结构的形态学影响

发布时间：2018-06-28 18:45

本文选题：二尖瓣成形术 + 经食管实时三维超声　；参考：《上海交通大学学报(医学版)》2017年03期

【摘要】：目的·利用经食管实时三维超声定量评估成形术对二尖瓣三维结构的形态学影响。方法·收集36例二尖瓣脱垂手术组患者瓣膜成形前后及56例对照组患者的三维超声资料,采集瓣环及瓣叶三维结构参数并对比分析。结果·术前手术组椭圆指数、非平面夹角小于对照组,其余参数大于对照组,差异有统计学意义。术后瓣环的前后径、前外后内直径、椭圆指数、最小三维周长、二维投影中的面积、最小三维面积及瓣叶的前瓣叶暴露面积、交界直径小于对照组,瓣环非平面夹角大于对照组,差异有统计学意义;其余参数与对照组比较,无明显差异。后叶人工腱索技术组与瓣叶三角形或矩形切除技术组手术前后各参数均无明显差异。结论·成形术可对二尖瓣功能进行满意纠治,但从形态学角度观察,术后瓣环形态并没有恢复至正常,而瓣叶的三维形态基本得到满意纠治。人工腱索技术与瓣叶三角形或矩形切除技术对后叶脱垂的形态学疗效相仿。
[Abstract]:Objective to evaluate the morphologic changes of mitral valve by transesophageal real-time three-dimensional ultrasound. Methods three dimensional ultrasound data were collected from 36 patients with mitral valve prolapse before and after valvuloplasty and 56 patients with control group. The three dimensional structural parameters of annulus and lobes were collected and analyzed. Results the elliptic index and non-plane angle of the operation group were lower than those of the control group, and the other parameters were larger than those of the control group, the difference was statistically significant. The anteroposterior diameter, anterior and posterior diameter, elliptic index, minimum three-dimensional circumference, area in two-dimensional projection, minimum area of anterior lobe and the area of anterior lobe exposure were smaller than those of the control group, and the diameter of the anterior lobe was smaller than that of the control group. The nonplanar angle of valve annulus was higher than that of control group, the difference was statistically significant, and the other parameters had no significant difference with the control group. There was no significant difference between the posterior lobe artificial chordae tendineae technique group and the flap triangular or rectangular resection group before and after operation. Conclusion Mitral valvuloplasty can be used to correct the mitral valve function satisfactorily, but from the morphological point of view, the annular shape does not return to normal, and the three-dimensional shape of the valve lobe is basically satisfactorily corrected. The effect of artificial chordae tendineae on posterior lobe prolapse was similar to that of triangular or rectangular flap resection.
【作者单位】：上海交通大学附属胸科医院心血管外科;上海交通大学附属胸科医院超声科;
【基金】：上海市胸科医院科技发展基金(YZ2015-ZX03,2014YZDH10302,2014YZDH10301) 上海市卫生和计划生育委员会科研课题(201540309)~~
【分类号】：R654.2

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