【摘要】 目的总结风湿性二尖瓣狭窄合并小左心室患者的外科治疗经验。方法回顾性分析佛山市第一人民医院2008年8月至2016年7月收治的40例接受外科手术治疗的风湿性二尖瓣狭窄合并小左心室患者的临床资料。结果术后心功能Ⅰ级、Ⅱ级患者比例明显上升,心功能Ⅲ级、Ⅳ级患者比例显著降低,与术前比较,差异有统计学意义(P<0.05)。术后患者左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、左心室舒张末期容积指数(LVEDVI)上升,左心房内径(LAD)、术前肺动脉收缩压(SPAP)、中心静脉压(CVP)均降低,与术前比较,差异有统计学意义(P<0.05)。患者术后并发症发生率为17.50%,病死率为5.00%。结论为提高风湿性二尖瓣狭窄合并小左心室外科手术效果,减少术后并发症发生率,必须重视围术期处理,且术中必须重视患者的心肌保护。更多还原

【Abstract】 Objectives To summarize the experience of surgical treatment of patients with rheumatic mitral stenosis complicated with small left ventricle. Methods Clinical data of 40 patients with rheumatic mitral stenosis complicated with small left ventricle treated in The First People′s Hospital of Foshan City from August 2008 to July 2016 were retrospectively analyzed. Results Percentages of patients with grade Ⅰ and grade Ⅱ cardiac function significantly increased(P<0.05),while percentages of patients with grade Ⅲ and Ⅳ cardiac function significantly decreased(P<0.05). After surgery,left ventricular end diastolic dimension(LVEDD),left ventricular ejection fraction(LVEF)and left ventricular end-diastolic volume index(LVEDVI)increased,while left atrial diameter(LAD),systolic pulmonary artery pressure(SPAP)and central venous pressure(CVP)decreased. Compared with those before surgery,there were significant differences(P<0.05). Incidence of complications after surgery and mortality were 17.50% and 5.00% respectively. Conclusions To improve the effect of surgical treatment of rheumatic mitral stenosis with small left ventricle and reduce the incidence of complications after surgery,attention should be paid to perioperative treatment and myocardial protection of patients.更多还原