摘要
目的 分析探讨心脏瓣膜置换术的中远期疗效。方法 1978年至 2 0 0 1年 12月 ,行瓣膜置换手术 2 14 1例 ,同期随访 16 81例 ,计 80 2 1 1人·年 ,平均 4 77人·年。通过回顾病因、手术方式、瓣膜类型等因素 ,观察术后病人心功能改善情况 ,病死率及并发症等 ,采用t检验 ,多因素回归等统计学方法分析。结果 92例死亡。总体生存率 5年为 (92 3± 2 2 ) % ,10年生存率为 (90 1± 2 7) %。并发症有血栓栓塞、机械瓣膜功能障碍、瓣周漏、溶血、机械瓣膜感染性心内膜炎。术后心功能 (NYHA)与术前比较有明显的提高。结论 1.机械瓣置换术后中远期疗效满意 ,病死率及并发症均较低 ;与术前心功能和手术种类直接相关 ;2 .使用保留瓣下结构及三尖瓣成形术对术后心功能恢复有明显效果 ;3.术中良好心肌保护是提高手术成功率的关键。
Objective: To analyze the mid long term results of prosthetic valves replacement. Methods: 2?141 patients underwent prosthetic valve replacement from 1978 to 2001, and 1?681 patients were followed up by completion of 78.5%, cumulate of 8?021.1 patient years and averages of 4.77 patient years each. The data were analyzed by multi factor regression and T test. Results: 92 patients died after operation. The 5 year and 10 year survival rates were (92.3±2.2)% and (90.1±2.7)%, respectively. The main complications were thromboembolism, valve mechanical malfunction, peri prosthetic leak, hemolysis and SBE. The heart function (NYHA) was significantly improved after valve replacement. Conclusion: The mid long term results of prosthetic valve replacement are rather satisfactory with low mortality and morbidity. Subvalvular structure preservation and tricuspid annuloplasty contribute can greatly improved heart function. Satisfactory myocardial protection during CPB is the key of successful operation.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2003年第4期197-199,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
