摘要
目的 总结心脏生物瓣膜置换术后远期随访结果 ,分析与远期死亡有关的危险因素 ,提出生物瓣置换的相宜适应证。方法 1984年 9月至 1988年 3月 ,90例生物瓣置换术者中男 39例 ,女 5 1例 ;平均年龄 36 1岁。风湿性心脏瓣膜病 78例 ,退行性病变 8例 ,先天性二尖瓣畸形 3例 ,三尖瓣下移畸形 1例。术前心功能II级 15例 ,III级 5 4例 ,IV级 2 1例。X线胸片示心胸比率 0 5 1～ 0 90 ,平均0 6 5～ 0 10。结果 术后死亡 7例。长期随访 83例 ,随访时间 3～ 187个月 ,共随访 6 78人·年。随访中死亡 35例 ,二次手术 2 0例。术后 1年、5年、10年生存率分别为 92 7%、80 7%、5 7 8%。并进行多因素回归分析。结论 心脏生物瓣膜置换术病人术前心功能 (P =0 0 2 )、心胸比率 (P =0 0 3)、EF值 (P =0 0 2 )与远期死亡明显相关。
Objective: To evaluate the long-term result after bioprosthesis replacement, and analyse the risk factors of the late deaths. Methods: From September 1984 to March 1988, 90 patients underwent bioprosthesis replacement in our hospital. There were 39 males (43%) and 51 females (57%) with an average age of 36.1 years. 78 patients had rheumatic disease, 8 degenerative disease, 3 congenital mitral valve anomaly and 1 Ebstein's anomaly. The preoperatively heart function (NYHA) was grade II in 15, grade III in 54, and grade IV in 21. C/T was 0.51～0.90 (average 0.65±0.10). Results: The operative mortality rate was 7。8%. All survived patients were followed up. The mean follow-up time was 7.8 years (range from 3 months to 15.7 years. 35 patients died during the follow-up period. The causes of death cardiac related deaths in 33 patients (88.6%), noncardiac related death in 3 (8.6%), and unknown in 1 (2.8%). Reoperation was performed in 20patients. At 1, 5 and 10 years after operation, the actuarial survival rate of patients were 92.7%, 80.7% and 57.8%, respectively. Multiple regression analysis showed that preoperatively cardiac function, C/T ratio and EF were risk factors for late deaths. Conclusion: The long-term results with bioprosthesis replacement appear satisfactory.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2003年第6期327-329,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
