【摘要】 目的　观察老年风湿性心脏病二尖瓣狭窄患者经皮气囊二尖瓣成形术 (PBMV)的效果。方法　 34名患者 ,其中男 1 4例 ,女 2 0例 ,年龄 55～ 71 (61 5± 9 4)岁。采用Inoue管或国产导管进行PBMV并观察手术前后心功能 ,血流动力学和瓣膜超声形态变化及并发症。结果　二尖瓣面积由 (0 92± 0 2 3)cm2 增至 (1 97± 0 52 )cm2 (P <0 0 1 ) ;二尖瓣跨瓣压由 (2 54± 1 1 3)kPa下降至 (0 63± 0 52 )kPa(P <0 0 1 ) ;左心房压从 (3 0 2± 1 34)kPa降至 (1 67± 1 0 2 )kPa(P <0 0 1 ) ;术后新出现二尖瓣返流 7例 ,返流加重 6例 ,但不影响疗效。 3例术中发生脑栓塞。 1 5例在 0 5～ 3年内复诊的患者中有 3例因二尖瓣再狭窄伴心功能恶化而住院。结论　PBMV对老年二尖瓣狭窄亦能取得较好的效果 ,但病例选择、手术操作有其特殊性更多还原

【Abstract】 Objective To observe the immediate outcome of 34 patients who underwent percutaneous mitral valvotomy (PMV). Methods Fourteen male and 20 female patients with mean age of 61 5(55～17) years were observed.Of them, 10 had undergone mitral commissurotomy previously.Results The procedure resulted in an increase in MVA from 0.92±0.23cm 2 to 1.97±0.52cm 2 (P<0.01) and decrease in mitral valve pressure gradient from 2.54±1.13 kPa to 0.63±0.52kPa(P<0 01). No death occurred, but cerebral thromboembolism developed in three. Conclusion It is indicated that the PBMV can be peformed safely in selected elderly patients with a satisfactory immediate outcome.更多还原