周鑫志　刘博

[摘要] 目的 探讨在风湿性心脏病二尖瓣重度狭窄伴小左心室患者治疗中予以外科治疗的临床价值。 方法 抽取2013年3月～2016年9月因二尖瓣替换到我院治疗的患者90例为研究对象，将其分为小左心室患者60例（观察组）、非小左室患者30例（对照组）。全部患者行外科治疗方式开展相关医治工作，探讨治疗后患者左心室改善情况、患者死亡率及术后患者的生活质量评分。 结果 90例患者经外科手术治疗后，其左心室舒张末期内径、后壁厚度、射血分数及舒张末期容积指数较治疗前均明显改善（P<0.05），观察组与对照组手术治疗后生活质量均显著提升，但两组患者间无显著差异（P>0.05），两组患者死亡率比较无明显差异（P>0.05）。结论 开展外科治疗方式治疗风湿性心脏病二尖瓣重度狭窄伴小左心室疾病，患者左心室的改善情况较佳，除增加患者左心室后壁厚度外，其左心室射血分数及舒张末期容积指数等均明显增加。

[关键词] 风湿性心脏病二尖瓣重度狭窄；左心室射血分数；死亡率；舒张末期容积指数

[中图分类号] R654.2 [文献标识码] B [文章编号] 1673-9701（2017）23-0048-03

[Abstract] Objective To explore the clinical value of surgical treatment of rheumatic heart disease severe mitral stenosis complicated with small left ventricular disease. Methods The 90 patients who were referred to our hospital due to mitral valve and were treated in our hospital From March 2013 to September 2016 were collected as the study subjects. They were divived into 60 patients with small left ventricular disease（observation group） and 30 patients with non-small left ventricular disease （control group）. All patients were given surgical treatment to carry out relevant treatment works. The improvement of left ventricle after treatment， the mortality rate of patients and the quality of life scores after the surgery were investigated. Results After surgical treatment in all 90 patients， the left ventricular end diastolic dimension， posterior wall thickness， ejection fraction and end-diastolic volume index were significantly improved compared with those before treatment（P<0.05）. The quality of life in the observation group and the control group after surgical treatment were significantly improved， but there was no significant difference between the two groups（P>0.05）. There was no significant difference in mortality between the two groups（P>0.05）. Conclusion After the surgical treatment of rheumatic heart disease severe mitral stenosis complicated with small left ventricular disease， the improvement of the left ventricle is better. In addition to increasing the thickness of the left ventricular posterior wall of the patient， the left ventricular ejection fraction and end-diastolic volume index are significantly increased， which is of the value of implementation and application in the treatment of such types of diseases.

[Key words] Rheumatic heart disease severe mitral stenosis； LVEF； Mortality rate； End-diastolic volume index

風湿性心脏病是心内科常见疾病之一，其发病原因主要是因为风湿性炎症使心脏瓣膜受到损伤，患者心律失常容易引起心脏衰竭[1]。风湿性心脏病不仅直接影响患者的生活质量，严重时还会危及患者生命健康与安全[2]。研究显示在风湿性心脏病的发生率中，二尖瓣狭窄所占比例较大，严重威胁着患者的身体健康。对于该类疾病最有效的治疗方式首选手术方式，即外科手术治疗使患者的瓣膜得以置换[3]。基……