2022 年第 9 期 第 17 卷

瓣膜成形术是目前风湿性二尖瓣病变手术的最佳选择

Valvuloplasty is the best choice for rheumatic mitral valve disease

作者：罗天戈张海波

英文作者：Luo Tiange Zhang Haibo

单位：首都医科大学附属北京安贞医院瓣膜外科中心，北京100029

英文单位：Valve Surgery Center Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：风湿性心脏瓣膜病；二尖瓣成形术；瓣膜修复术；二尖瓣置换术

英文关键词：Rheumaticheartvalvedisease;Mitralvalvuloplasty;Valverepair;Mitralvalvereplacement

• 摘要：

• 风湿性心脏瓣膜病目前仍是我国二尖瓣外科手术的首要病因，外科手术是目前终末期风湿性二尖瓣病变最有效的治疗方式，其主要的治疗方案包括保留原有瓣膜的瓣膜成形术和去除原有瓣膜的人工瓣膜置换术2种。近年来，部分临床研究已证实风湿性二尖瓣成形术（也称瓣膜修复术）相较于瓣膜置换术在患者预后中的显著优势。孟旭教授团队通过对国人风湿性心脏瓣膜病变病理特征的研究，创造性地将风湿性二尖瓣成形术总结规范为“四步法”，促进了该治疗理念及技术在全国范围内的推广和应用。风湿性二尖瓣成形术的安全性和远期效果已经得到证实，相较于人工瓣膜置换，瓣膜成形术可以得到满意的临床和社会效果。

• At present, rheumatic valvular heart disease is still the primary cause of mitral valve surgery in China, and the surgical surgery is the most effective treatment for end-stage rheumatic mitral valve disease. The main treatment options include valvuloplasty with preserved original valve and prosthetic valve replacement with original valve removed. In recent years, some clinical studies have confirmed that rheumatic mitral valvuloplasty (valve repair) has a significant prognostic advantage over replacement. By studying the pathological characteristics of rheumatic heart valve diseases in China, professor Meng Xu′s team creatively summarized and standardized rheumatic mitral valve repair as a "four steps", which promoted the promotion and application of this treatment concept and technology in the whole country. The safety and long-term effects of rheumatic mitral repair have been proven, compared with artificial valve replacement, valvuloplasty can achieve satisfactory clinical and social results.