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改良De Vega環(huán)縮術治療重度三尖瓣返流的療效分析

摘要:目的:探討改良De Vega環(huán)縮術與經(jīng)典De Vega環(huán)縮術相比對于治療重度三尖瓣返流是否具有更好的成形效果。方法: 2007年12月至2009年3月對29例重度三尖瓣返流的患者行De Vega環(huán)縮術。其中16例行改良De Vega環(huán)縮術,13例行經(jīng)典De Vega環(huán)縮術,隨訪比較兩組患者三尖瓣返流程度,右心室舒張期末內(nèi)徑,EF值及心功能分級。以秩和檢驗分析研究兩組患者三尖瓣返流程度和心功能分級的差異,以t檢驗研究兩組患者右心室舒張末期內(nèi)徑及EF值變化。結果:術前兩組患者一般指標無顯著差異。兩組患者隨訪時間無顯著差異。隨訪經(jīng)典De Vega組重度返流1例,中度返流5例,輕度返流5例,微量及無返流2例;改良De Vega組無中、重度返流,輕度返流8例,微量及無返流8例。經(jīng)分析顯示兩組患者三尖瓣返流程度結果差異有統(tǒng)計學意義(Plt;0.05)。經(jīng)典De Vega組心功能分級I級5例,II級7例,III級1例;改良De Vega組I級7例,II級8例,III級1例,兩組患者心功能差異無統(tǒng)計學意義(Pgt;0.05)。兩組患者右室舒張期末內(nèi)徑及EF值組內(nèi)比較隨訪與術前差異均有統(tǒng)計學意義(Plt;0.05),隨訪時組間比較差異有統(tǒng)計學意義(Plt;0.05), 改良De Vega環(huán)縮術隨訪時右室舒張期末內(nèi)徑縮小更顯著,射血分數(shù)改善更明顯。結論:改良De Vega環(huán)縮術治療重度三尖瓣返流效果優(yōu)于經(jīng)典De Vega環(huán)縮術。Abstract: Objective: To compare the efficacy of one kind of modified De Vega technique and traditional De Vega technique for the correction of severe tricuspid regurgitation. Methods: From December 2007 to March 2009, 29 patients were treated with tricuspid valve annuloplasty. These were 16 patients in modified De Vega annuloplasty group and the others (13 patients) in traditional De Vega annuloplasty group. The grade of tricuspid regurgitation、New York Heart Association (NYHA) functional class、ejection fraction (EF) and the right ventricular enddiastolic dimension of two groups were followed and reviewed. Results: There was no statistically difference between two groups about preoperative characteristics and followup time. There was 1 patient with severe TR, 5 patients with moderate TR, 5 patients with mild TR and 2 patients without TR in traditional De Vega annuloplasty group after the operations. In modified De Vega annuloplasty group, no patient was observed with severe or moderate TR, 8 patients with mild TR, and 8 patients without TR. At interval time, there was significant difference in the grade of tricuspid regurgitation between two groups (Plt;0. 05). Both tricuspid valve plasty techniques could reduce the right ventricular enddiastolic dimension and improve ejection fraction significantly (Plt; 0. 05), and there was significant difference in the right ventricular enddiastolic dimension and ejection fraction at interval time between two groups (Plt;0.05). Conclusions: The outcome of modified tricuspid De Vega technique is superior to that of traditional De Vega technique in correcting severe tricuspid regurgitation.