| Objective：To Explore the treatment of rheumatic mitral stenosis and mitralvalve with moderate to severe regurgitation clinical by balloon angioplasty.Methods：Randomly selected56cases of rheumatic heart disease patients,divided into three groups, group A:30cases of pure mitral stenosis, with mild or nomitral regurgitation; group B:10cases of mitral stenosis combined with moderateregurgitation; group C:16cases: mitral stenosis and severe reflux. Inoue balloontechnique improved through a gradual expansion method for treatment. Collectpreoperative, postoperative and follow-up echocardiographic and clinical evaluationof data for analysis.Result：1.Group A mitral valve area (Mitral valve area, MVA) increased from0.85±0.22cm~2preoperatively to1.69±0.41cm~2, to1year after operation was1.67±0.40cm~2(P <0.01); B group of mitral valve area (Mitral valve area, MVA) increased from0.83±0.18cm~2preoperatively to1.45±0.35cm~2, to1year after operationwas1.38±0.32cm~2(P <0.01); Group C mitral valve area (Mitral valve area, MVA)increased from0.91±0.30cm~2pr-eoperatively to1.48±0.26cm~2, to1y-ear afteroperation w as1.39±0.27cm~2,(P <0.01).2. Group A reflux area by0.82±1.24cm~2to2.80±4.15cm~2, to1year after oper-ation was2.78±4.05cm~2(P=0.008; P=0.008); Group B reflux area by6.21±0.88cm~2to4.39±2.25cm~2, to1year after operation was4.32±2.23cm~2(P=0.014; P=0.014); Gro-up C reflux area by10.06±1.25cm~2to7.78±3.34cm~2, to1year afteroperation was7.48±3.18cm~2(P=0.007; P=0.007).3. Group A left atrial size to improve the curative effect of47.93±7.02mm to44.90±7.23mm,to1year after operation was41.07±7.23mm (P=0.001; P <0.01);Group B to improve curative effect of left atrial size49.70±3.53mm to45.40mm, to1yearafter operation was45.40±4.77mm (P=0.009; P=0.009); Group C to improvecurat-ive effect of left atrial size54.09±8.27mm to49.44±5.96mm, to1year after operation was47.19±5.95mm (P=0.021; P=0.021).4. Different illness group follow-up curative effect comparison: Through theLSD me-thod two is visible, In terms of aortic area of improvement, Group Acompared with B and C group effect is good, there was no difference in the group Band C (see table7); In terms of reflux area, Group C effect is good, but A and Bgroups improve similar,no statistical difference (see table9); In terms of left atrial size to improve,Group B and there was no difference in the other two groups, group A and group Chas A diffe-rence (see table11).Conclusion：Between groups who suffer mitral balloon dilatation respectivelyafter treatment, mitral valve orifice area were significantly increased compared withpreop-erative, Have a statistically significant difference (P <0.01, as shown in table3,6). In mitral regurgitation in group A are obviously increased, but not affectcurative effect; There is a decrease in the reflux area B and C group, group C duringfollow-up fell2.58±2.77to1.89±1.87good compared with group B, two groups haveobvious differe-nce compared with preoperative (see table4,8). Postoperative leftatrium a preoperat-ive three group was obviously reduced (see table5,10), So themerger of rheu-matic heart disease mitral stenosis, severe reflux feasible balloondilatation therapy. |
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