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随机试验的部分与完整的带保护方法的中枢替换:初步报告
K L Yun1, C F Sintek, D C Miller
1Department of Cardiac Surgery, Kaiser Permanente Medical Center, Los Angeles, CA, USA. Kwok.L.Yun@kp.org
Circulation
|November 24, 1999
概括
在米特拉置换过程中完整的带保护改善了心脏功能并减少了腔室体积,提供了与米特拉修复相当的好处. 这种方法提高了弹射性能,并减少了缩壁应力.
科学领域:
- 心血管外科心血管外科
- 心脏机械学 心脏机械学
- 中心门疾病的疾病.
背景情况:
- 在慢性 mitrale 排泄症中,在 mitrale 置换中保留子器械是临床上有益的.
- 在左心室力学上完全或部分带保护的早期影响需要进一步分析.
研究的目的:
- 评价完整的和弦保存与部分的和弦保存对左心室机械的早期影响.
- 为了将这些效应与初级 mitra 门修复进行比较.
主要方法:
- 预期随机分选50名接受隔离性 mitrale 不足纠正的患者,分为整体或部分带状节约性 mitrale 置换组.
- 心声学在手术前和出院时进行,以评估左心室尺寸,壁应力和喷射率.
- 与一组6名接受初级 mitra 门修复的患者进行了比较.
主要成果:
- 部分带保护 (仅在后面的小册子上) 导致终端透缩体积减少,终端静缩体积增加,喷射分数显著下降 (0.68至0.46).
- 完整的带状脉保存导致末端透析体积减少,末端静脉压力减少,喷射分数 (0.60至0.52) 减少较小.
- 与部分保存相比,完整的带状保护显示出更好的喷射性能和减少缩壁应力,与 mitra 修复相比没有显著差异.
结论:
- 在米特拉更换过程中,完全保留子膜器官可以提高弹射性能并减少腔室体积.
- 减少缩壁应力是完整的带保护的血液动力学优势的一个关键因素.
- 完整的带保护的好处与初级带重建所获得的好处相似.
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