小主动脉瓣环患者环上瓣置入后临床效果分析
发布时间：2019-01-01 14:17
【摘要】：目的总结主动脉环上瓣在成人小主动脉瓣环患者瓣膜置换术中的临床应用,提高手术效果。方法选择2008年11月-2016年3月间62例小主动脉瓣环患者行环上瓣(ATS.AP)置换术及62例非小主动脉瓣环患者行常规机械瓣置换术,两组患者分别于术前、术后1周行超声心动图检查,检测并计算患者有效瓣口面积指数(EOAI)、左室射血分数(LVEF)、左室短轴缩短率(LVFS)、主动脉瓣峰值跨瓣压差(TAVPPG)、左室舒末径(LVEDD),观察两组患者术后人工瓣膜与体表面积不相匹配现象(PPM)发生率,评价手术效果。结果术后1周与术前相比较,复查超声心动图测得两组患者主动脉瓣峰值跨瓣压差(TAVPPG)明显下降(P均0.05),左室射血分数(LVEF)提高(P均0.05),左室短轴缩短率(LVFS)提高(P均0.05),左室舒末径(LVEDD)明显下降(P均0.05),有效瓣口面积指数(EOAI)明显提高(P均0.05),差异均有统计学意义。环上瓣(ATS.AP瓣)置换组与常规机械瓣置换组术前、术后1周上述指标改善差值相比较,差异均无统计学意义(P均0.05)。结论小主动脉瓣环患者行环上瓣(ATS瓣)置换术与非小主动脉瓣换患者行常规机械瓣置换术,术后复查超声心动图各项指标均得到改善,均可获得良好的血流动力学效果。环上瓣(ATS.AP瓣)组术后无人工瓣膜与体表面积不匹配(PPM)现象发生,左心功能各项指标及血流动力学改善与正常主动脉瓣环瓣膜置换患者无差异。
[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.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R654.2
，
本文编号：2397684
[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.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R654.2
，
本文编号：2397684
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