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目的应用超声心动图比较肥厚型梗阻性心肌病患者经皮经腔间隔心肌消融术与室间隔心肌切除术的疗效。方法分别于经皮经腔间隔心肌消融术及室间隔心肌切除术前、后测量肥厚型梗阻性心肌病患者左室流出道压差,比较术前及术后压差。结果肥厚型梗阻性心肌病患者在进行经皮经腔间隔心肌消融术与室间隔心肌切除术后,左室流出道压差均较术前明显减低。经皮经腔间隔心肌消融术肥厚型心肌病患者术前左室流出道压差(99±19)mm Hg(1 mm Hg=0.133 kPa),术后降至(36±20) mm Hg(P<0.05)。进行室间隔心肌切除术肥厚型心肌病患者术前左室流出道压差(117±32) mm Hg,术后降至(28±17) mm Hg(P<0.05)。经皮经腔间隔心肌消融术与室间隔心肌切除术患者术后左室流出道压差差异无统计学意义[(36±20)mm Hg比(28±17)mm Hg]。结论经皮经腔间隔心肌消融术可以明显减低肥厚型梗阻性心肌病患者左室流出道压差,且与室间隔心肌切除术疗效相似。
Objective To compare the efficacy of percutaneous transluminal septal myocardial ablation and septal myocardial resection in patients with hypertrophic obstructive cardiomyopathy by echocardiography. Methods The left ventricular outflow tract pressure was measured in patients with hypertrophic obstructive cardiomyopathy before and after percutaneous transluminal septal myocardial ablation and septal myocardial resection respectively. The preoperative and postoperative pressure differences were compared. Results In patients with hypertrophic obstructive cardiomyopathy, the pressure drop in left ventricular outflow tract was significantly lower than that before operation after percutaneous transluminal myocardial ablation and septal myocardial resection. Percutaneous transluminal myocardial ablation in patients with hypertrophic cardiomyopathy preoperative left ventricular outflow tract pressure (99 ± 19) mm Hg (1 mm Hg = 0.133 kPa), postoperative to (36 ± 20) mm Hg (P <0.05). Preoperative left ventricular outflow tract pressure was (117 ± 32) mm Hg in patients with hypertrophic cardiomyopathy who underwent intermyotrophic cardiomyctomy, and dropped to (28 ± 17) mm Hg after operation (P <0.05). There was no significant difference in postoperative left ventricular outflow tract pressure between patients with percutaneous transluminal myocardial septal ablation and those undergoing cardiac resection [(36 ± 20) mm Hg vs (28 ± 17) mm Hg). Conclusion percutaneous transluminal myocardial ablation can significantly reduce the hypertensive obstructive cardiomyopathy in patients with left ventricular outflow tract pressure, and resection of the resection of the resection of the heart resection is similar.