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僧帽瓣狹窄症의 手術前後에 關한 硏究

A Phonocardiographic Study of Mitral Stenosis Before After Commissurotomy

대한외과학회지 1970년 12권 1호 p.11 ~ 16
김우일,
소속 상세정보
김우일 (  ) - 서울대학교 의과대학 외과학교실

Abstract


A phonocardiogra phic study was conducted in 24 cases of pure or predominant mitral stenosis before and after commissurotomy and the following results were obtained.
1) The age distribution was between 17 and 44, and the average was 31 years. The ratio of male to female was 2:1.
2) The Q-I time ranged between 0.06 sec. and 0.10 sec., and the mean was 0.082 sec. before commissurotomy.
However, the mean of Q-I time was shortened to 0.077 sec. following commissurotomy.
3) The opening snap was observed in 23 cases (94.7%) among the total 24 cases preoperatively. However, postoperative phonocardiogram revealed opening snap in 19 cases, and in 4 cases the opening snap could not be noted.
4) The preoperative Ⅱ-OS time ranged between 0.04 sec. and 0.08 sec., and the mean was 0.055 sec. However, the mean of Ⅱ-OS time was prolonged to 0.067 sec. following commissurotomy.
5) The M-1 accentuation was observed in 23 cases (96.5%) of the total 24 cases, of which splitted first sound was noted in 18 cases (75.6%), but the M-1 accentuation became much decreased in the degree after the commissurotomy.
6) The accentuation of P-2 was in all cases before operation but it was much decreased in the degree after the operation.
7) The presystolic murmur was observed in 20 cases (84%) before operation but it could not be detected in 8 cases after commissurotomy.
8) The phonocardiographic index ranged between 1 and 5 before operation but the range became between 2 and 3 after commissurotomy.
In conclusion, the phonocardiogram is considered to be the most simple and accurate method of evaluation in mitral stenosis before and after commissurotomy.

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