二尖瓣成形环选择策略：全环与半环的临床 疗效分析
Selection Strategies for Mitral Valve Annuloplasty Rings: A Comparative Clinical Efficacy Analysis of Complete Rings and Partial Bands
DOI: 10.12677/acm.2026.1641620, PDF,   
作者: 王腾龙, 张成鑫*：安徽医科大学第一附属医院心脏大血管科，安徽 合肥
关键词: 二尖瓣修复术；瓣环成形术；左心室逆重构；Mitral Valve Repair； Annuloplasty； Left Ventricular Reverse Remodeling
摘要: 目的：对比全封闭成形环(Full Ring)与部分成形带(Partial Band)对退行性二尖瓣反流(DMR)患者术后早期左心室逆重构的影响。方法：回顾性分析198例行单纯二尖瓣修复术患者资料(全环组98例，半环组100例)。通过超声心动图对比术前及术后一周的容积指标，并建立多因素分层回归模型，评估装置类型及规格对疗效的独立贡献。结果：全组患者术后心脏容量指标均较术前显著下降(P < 0.001)，手术成功启动逆重构。组间容量改善幅度(ΔEDVI、ΔESVI)及残余反流差异无统计学意义(P > 0.05)。分层回归显示，术前容量指数是决定术后转归的最强预测因子；在校正基线因素后，成形装置类型对模型解释力的贡献极微(ΔR2仅0.003~0.005)。结论：全环与半环在促进早期逆重构方面临床等效。术后恢复主要受术前基线状态影响，临床选型应侧重解剖复位而非纠结装置形状。
Abstract: Objective: To compare the impact of full annuloplasty rings versus partial annuloplasty bands on early postoperative left ventricular reverse remodeling (LVRR) in patients with degenerative mitral regurgitation (DMR). Methods: A retrospective analysis was conducted on 198 patients who underwent isolated mitral valve repair (98 in the full ring group and 100 in the partial band group). Volumetric parameters were compared via echocardiography preoperatively and at one week postoperatively. Multivariable hierarchical regression models were established to evaluate the independent contributions of device type and size to the clinical outcomes. Results: Postoperative cardiac volume indices decreased significantly across the entire cohort compared to preoperative values (P < 0.001), indicating the successful initiation of reverse remodeling. No statistically significant differences were observed between the two groups regarding the magnitude of volume reduction (ΔEDVI, ΔESVI) or residual regurgitation (P > 0.05). Hierarchical regression revealed that preoperative volume indices were the strongest predictors of postoperative outcomes. After adjusting for baseline factors, the type of annuloplasty device contributed minimally to the model’s explanatory power (ΔR2 ranging from 0.003 to 0.005). Conclusion: Full rings and partial bands are clinically equivalent in promoting early LVRR. Postoperative recovery is primarily driven by preoperative baseline status; therefore, clinical device selection should focus on anatomical restoration rather than device geometry.
文章引用：王腾龙, 张成鑫. 二尖瓣成形环选择策略：全环与半环的临床 疗效分析[J]. 临床医学进展, 2026, 16(4): 3559-3571. https://doi.org/10.12677/acm.2026.1641620

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