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目的:观察外科手术治疗小儿动脉导管未闭(patent ductus arteriosus,PDA)合并中、重度功能性二尖瓣返流(mitral regurgitation,MR)的疗效。方法:回顾性分析2006年1月至2009年12月期间行外科手术治疗PDA合并MR的患者12例。分别于动脉导管结扎术后1周、3个月和1年复查心脏超声,观察左室内径、左室收缩功能及二尖瓣返流面积与左房面积之比(MR/LA)的变化。结果:12例术前诊断PDA合并中、重度MR患者均行动脉导管结扎术,术后均无残余分流。术后3月后心脏彩色多普勒测定左室舒张末期内径(LVEDD)、左室射血分数(LVEF)、左室短轴缩短率(FS)和MR/LA均较术前明显改善(P<0.05);LVEDD术后1年较术后3个月进一步降低(P<0.05)。结论:外科手术治疗中重度功能性MR的PDA安全、有效。
Objective: To observe the efficacy of surgical treatment of patent ductus arteriosus (PDA) combined with moderate and severe mitral regurgitation (MR). Methods: A retrospective analysis of 12 patients who underwent surgical treatment of PDA complicated with MR between January 2006 and December 2009 was performed. Cardiac echocardiography was performed at 1 week, 3 months and 1 year after ligation of the patent ductus arteriosus. Changes in left ventricular diameter, left ventricular systolic function, and mitral regurgitation to left atrial area ratio (MR / LA) were observed. Results: 12 cases of preoperative diagnosis of PDA with moderate and severe MR patients underwent catheterization of the arteries, no postoperative residual shunt. Left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), left ventricular fractional shortening (FS) and MR / LA were significantly improved 3 months after surgery <0.05). One year after LVEDD was further reduced (P <0.05) compared with 3 months after operation. Conclusions: Surgical management of PDA with moderate to severe functional MR is safe and effective.