Tei指数评价三尖瓣人工瓣环和DeVega成形术后患者右心室功能的临床.docVIP

Tei指数评价三尖瓣人工瓣环和De Vega成形术后患者右心室功能的临床研究 桂莹晶 张大发 皖南医学院第一附属医院 弋矶山医院 胸心外科二，安徽 芜湖 241001 【摘要】 目的 探讨Tei指数评价三尖瓣人工瓣环和De Vega成形术治疗三尖瓣关闭不全患者右心室功能的研究。方法 选取2012年01月至2016年12月，在皖南医学院第一附属弋矶山医院行二尖瓣置换术同期三尖瓣成形术共147例患者进行分析，根据手术方式的不同分为两组，其中人工瓣环组66例，采用进口的Edwards4600行人工瓣环成形术，De Vega成形组81例，采用De Vega成形术，收集所有患者术前一般资料，并对患者进行术后一周、一月、一年的随访，根据超声心动图检查测量术前术后右心房横径，右心室内径以及三尖瓣瓣环直径等指标，比较两组患者不同三尖瓣成形术的临床疗效，并运用组织多普勒超声的方法计算右室Tei指数评价右心功能。结果 两组患者术前一般资料比较，差异无统计学意义，两组患者术后一周右心房横径，右心室内径，三尖瓣瓣环直径、Tei指数等指标与术前相比显著降低，差异有统计学意义；人工瓣环组术后一年Tei指数、三尖瓣返流量和瓣环直径等指标与术后一周相比差异有统计学意义，两组患者术后组间比较，人工瓣环组Tei指数较小，差异有统计学意义（P0.05）。结论 三尖瓣人工瓣环成形术和De Vega成形术治疗三尖瓣关闭不全均有显著疗效，三尖瓣成形环在维持三尖瓣瓣环的形态和改善右心功能上效果更佳，Tei指数能在术后早期准确评价患者的右心功能。 【关键词】Tei指数，三尖瓣关闭不全，三尖瓣成形环，De Vega成形术 右心室功能 Clinical study on right ventricular function of the patients with tricuspid annuloplasty ring and De Vega tricuspid annuloplasty by Tei index GUI Yingjing，ZHANG Dafa Department of cardiothoracic Surgery,The first Affiliated Hospital of Wannan Medical College,Wuhu 241001,China 【Abstract】Objective:To investigate the value of Tei index in evalucating right ventricular function with the tricuspid annuloplasty ring and De Vega tricuspid annuloplasty for the treatment of tricuspid regurgitation Methods: 147 Patients received tricuspid valvuloplasty during valve replacement between January 2012 and December 2016 at the first affiliated hospital of Wannan Medical College were invovled in this study.The patients were divided into two groups according to the operation methods ,tricuspid annuloplasty ring group(n=66,treated with imported Edwards4600 tricuspid annuloplasty ring)and De Vega tricuspid annuloplasty group(n=81).We collected patients general information and did followed-up in one week,one month and one year after operation.The Tei index of right ventricular were mearsured by tissue Doppler imaging.The clinical efficacy and right ventricular function were evaluated by the diameter of right atrium the diameter of ventriculus dexter and the diameter of tricuspid annulus.Re