摘要
目的 超声心动图结合血流动力学导管监测观察二尖瓣成形术对严重二尖瓣关闭不全的治疗效果及左心功能的影响。方法 对30例中重度二尖瓣关闭不全的患者,于术前及术后早期进行超声心动图检查,成形术前麻醉诱导后及术后12 h Swan Ganz导管监测血流动力学指标。结果 术后20例患者经超声心动图检查返流信号完全消失,2 例探及中量返流信号;所有患者二尖瓣口开放面积无明显狭窄。左室舒张末期容积、每搏输出量、射血分数及舒张期左房、室间压差降低,E/Em无明显变化;肺循环阻力、肺动脉楔压等降低。结论 超声心动图对二尖瓣关闭不全的严重程度的评价及对病因的诊断与外科手术结果吻合,对成形术疗效及手术前后心功能的评判与血流动力学监测基本相符。
Objective To evaluate the clinical effect of the mitral valve plasty to treat the severe mitral valve insufficiency, at the same time, observe the change of the left ventricular function after the operation by echocardiography and the hemodynamic catheter monitoring. Methods Thirty patients with moderate to severer mitral valve insufficiency underwent echocardiography pre and post-operatively, and hemodynamic monitoring by using the Swan-Ganz catheter after anesthesia untill 12 h post-operation. Results In post-operating echocardiography, the regurgitations were found disappeared completely in 20 patients and the moderate regurgitation was found in 2 patients. The significant mitral valve stenosis had not been found in all patients. The volume at the end of the diastole of left ventricle, the stroke volume and the ejection fraction, as well as the pressure gradient between the left atrium-ventricle were declined significantly, the pulmonary arteriolar wedged pressure (PAWP), the mean pulmonary vessels pressure (MPAP), the pulmonary vessels resistant index (PVRI), and the systemic vessels resistant index (SVRI) were decreased, but the E/Em had no significant change. Conclusion The severity and cause of the mitral valve insufficiency assesses by echocardiography were confirmed in the operation, the evaluation on the left heart function and effect of the operation were the same as that with the hemodynamic monitoring.
出处
《中国医学影像技术》
CSCD
北大核心
2005年第6期883-886,共4页
Chinese Journal of Medical Imaging Technology
