摘要
本文报道自1960至1986年为61例闭式二尖瓣交界分离术后再狭窄的病人施行第二次手术治疗的经验。其中36例施行闭式二尖瓣交界分离术,11例作直视二尖瓣交界切开术,14例施行二尖瓣替换术。住院死亡率为4.9％。术后生存的58例都得到随访,心功能均有明显改善。在36例施行闭式二尖瓣交界分离术者中,10年后有3例因再次狭窄施行第3次手术。本文对3种手术方法进行了比较,结果表明:二尖瓣替换术仅用于瓣膜严重损坏者;闭式手术较简单,手术死亡率也低;直视手术能精确分离瓣膜交界和瓣下结构,必要时可同时施行瓣膜成形术,术后复发率低。
From January 1960 to December 1986, 61 consecutive patients with postoperative mitral restenosis were operated on. There were 43 males and 18 females, with ages range from 26 to 53 years, average 41 years. Closed commissurotomy, open commissurotomy and mitral valve replacement were performed in 36, 11 and 14 cases respectively, with a hospital mortality of 4.9%. All the cases were followed up. Of the 58 survivors, 50 had improved by at least one NYHA class. In 36 cases of closed commissurotomy group, 3 needed third operation 11, 14, 15 years after the second operation respectively because of restenosis. Closed commissurotomy was the most simple operation and its operative mortality was the lowest. In open commissurotomy, the mitral valve and subvalvular struc- tures could be dissected precisely and restenosis rate was lower. Mitral valve replacemen was indicated in patients with severely deformed or heavily calcified valve.
出处
《上海医学》
CAS
CSCD
北大核心
1989年第1期4-7,共4页
Shanghai Medical Journal
