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目的 分析和总结伴有特殊情况的左房室瓣狭窄球囊扩张术(PBMV)的临床疗效和安全性。方法 收集我院自1986年12月至2 0 0 5年1月施行的2 30 0例风湿性心脏病左房室瓣狭窄(MS)病例,其中有特殊情况者6 2 1例。包括非单纯MS(合并左房室瓣关闭不全或主闭)者32 8例;非单纯的MS伴巨大左房者15例;巨大左房者10 6例;左房血栓者5 2例;巨大左房及左房血栓者4例;PBMV或左房室瓣闭式分离术后者79例;PBMV或左房室瓣闭式分离术后非单纯的MS者34例;妊娠大咯血者2例。采用Inoue球囊技术。结果 手术成功率98.5 % ,失败率0 .2 % ;发生严重并发症8例,并发症为1.3% ,其中急性左心衰2例,低心排1例,脑栓塞2例,心脏压塞3例。因急性左心衰、低心排、心脏压塞、脑栓塞造成的死亡各1例。结论 随着操作技巧的不断完善,许多伴有特殊情况的PBMV可安全、有效的接受手术。但术前一定要全面评价瓣膜、心功能、血栓情况
Objective To analyze and summarize the clinical curative effect and safety of left atrioventricular valve stenosis balloon dilatation (PBMV) with special cases. Methods A total of 230 cases of left atrioventricular valve stenosis with rheumatic heart disease were enrolled in our hospital from December 1986 to January 2005, of which 621 cases were special cases. Including non-simple MS (merger of atrioventricular valve insufficiency or main closure), 32 8 cases; non-simple MS with huge left atrium in 15 cases; 106 cases of huge left atrium; left atrial thrombus in 52 cases; huge Left atrial and left atrial thromboembolism in 4 cases; PBMV or left atrioventricular valve closure in 79 cases; PBMV or left atrioventricular valve after non-simple MS in 34 cases; pregnancy, severe hemoptysis in 2 cases . Inoue balloon technology. Results The success rate of operation was 98.5% and the failure rate was 0.2%. There were 8 serious complications and 1.3% complications, including 2 cases of acute left heart failure, 1 case of low cardiac output, 2 cases of cerebral embolism, 3 cases of cardiac tamponade example. One case died of acute left heart failure, low cardiac output, cardiac tamponade and cerebral embolism. Conclusion With the continuous improvement of operating skills, many PBMV with special circumstances can safely and effectively accept surgery. But before surgery must fully evaluate the valve, cardiac function, thrombosis