摘要
目的 了解左心室巨大室壁瘤手术治疗的中、远期效果。 方法 采用多次信访、电话随访和门诊复查相结合的方法 ,对 5 8例左心室巨大室壁瘤行手术治疗后生存的 5 6例患者中的 49例进行了随访 ,随访率 87 5 %,随访时间 (4 7 6± 2 2 4 )个月 ,随访时间最长者 90 0个月。 结果 患者随访期内死亡 10例 ,5年生存率为 6 3 7%。术后患者左心室舒张末径有明显缩小 ;术后 2 9 0个月左心室射血分数与术前相比 ,有显著提高。所有患者均无再次心肌梗死发生 ,心绞痛复发 6例 ,程度较术前减轻。NYHA心功能分级由术前的 (2 5± 0 7)级转为 (1 3± 0 5 )级。统计分析显示 ,左心室舒张末径大于 70mm及左心室射血分数小于 35 %,为独立相关危险因素。 结论 左心室巨大室壁瘤手术治疗患者 ,中、远期疗效较好 ,绝大部分无心绞痛发生 ,生活质量提高 ,生存率与国外报道相似。
Objective To assess the mid-term outcome of the patients with left ventricular aneurysm repaired, and analyze the factors influencing early and late mortality and morbidity. Methods From January 1992 to November 1998, 58 patients underwent surgical repair for postischemic left ventricular aneurysm.In the 56 survivals, 49 patients (87.5%) were followed-up for an average of 47.6 months (the longest time was 90.0 months). Results Early mortality rate was 3.4% (2 patients). In the follow-up period (mean 47.6±22.4 months), 10 patients died. The 5-year survival rates were 63.7%. The left ventricular end-diastolic diameter and left ventricular ejection fraction were improved significantly 29.0 months after operation. There was significant improvement in mean NYHA (from class 2.5±0.7 to 1.3±0.5). Of the survivors, 43 (87.8%) were free from angina, and 7 had arrhythmias. Multivariate analysis showed that left ventricular end-diastolic diameter larger than 70 mm and left ventricular ejection fraction lower than 35% were independent risk factors. 33% patients were free from drugs. Conclusion Left ventricular aneurysm repair is an important therapeutic intervention and can be performed successfully. Patients who could benefit from the operation are those with a normal postoperative contraction pattern.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2001年第12期928-930,共3页
Chinese Journal of Surgery
关键词
心脏室壁瘤
心脏外科手术
随访研究
疗效
Heart aneurysm
Cardiac surgical procedures
Follow-up studies
