摘要
目的:探讨心脏瓣膜病患者人工心脏瓣膜置换术预后的影响因素。方法:回顾性分析2015年3月~2017年9月在我院行人工心脏瓣膜置换术的103例心脏瓣膜病患者的临床资料。采用门诊复查和电话随访的方式进行术后随访,收集患者性别、年龄、原发病、基础病、心功能、手术方式、术后并发症、超声心动图参数等各项数据,分析预后影响因素。结果:103例患者均顺利完成人工心脏瓣膜置换术,术后随访12~42个月,平均(30.5±14.3)个月。至随访截止8例(3.8%)死于严重低心排出量,5例(2.4%)死于多器官功能衰竭,5例(2.4%)死于严重心律失常,3例(1.4%)死于感染性心内膜炎。单因素和多因素Logistic回归分析显示:年龄>60岁、病程>15年、合并糖尿病、合并肾功能不全、心功能Ⅲ~Ⅳ级、左心房内径>70mm、左心室射血分数≤50%、并发低心排出量、体外循环时间>3h、主动脉阻断时间>2h、均是影响患者预后的独立危险因素。结论:心脏瓣膜病患者人工心脏瓣膜置术的预后受年龄、病程、基础疾病、心功能、术后并发症、体外循环和主动脉阻断时间等多种因素的影响,临床上应根据这些危险因素采取相对应的预防措施,从而改善预后。
Objective To investigate the prognostic analysis of prosthetic heart valve replacement in patients with valvular heart disease.Methods The clinical data of 103 patients with valvular heart disease underwent prosthetic heart valve replacement in our hospital from March 2015 to September 2017 were retrospective analyzed.The outpatient follow-up and telephone follow-up were used to collect the data of sex,age,primary disease,basic disease,cardiac function,operation methods,postoperative complications,echocardiographic parameters.The risk factors affecting prognosis of patients were analyzed.Results All 103 patients underwent successful prosthetic heart valve replacement.The follow-up period ranged from 12 months to 42 months,with an average of(30.5±14.3)months.,8(3.8%)died of severe low cardiac output,5(2.4%)died of multiple organ failure,5(2.4%)died of severe arrhythmia,and 3(1.4%)died of infective endocarditis.Univariate and multivariate logistic regression analysis showed that age>60 years,course of disease>15 years,diabetes mellitus,renal insufficiency,gradeⅢ~Ⅳcardiac function,left atrial diameter>70mm,left ventricular ejection fraction<50%,low cardiac output,cardiopulmonary bypass time>3h,aortic occlusion time>2h were all risk factors.Conclusion The prognosis of artificial heart valve replacement in patients with heart valve disease is affected by age,course of disease,underlying disease,cardiac function,postoperative complications,cardiopulmonary bypass and aortic occlusion time,and so on.Corresponding preventive measures should be taken according to these risk factors to improve the prognosis.
作者
汤丹丹
程明光
Tang Dan-dan;Cheng Ming-guang(The First Affiliated Hospital of China University of Science and Technology(Anhui Provincial Hospital),Hefei 230001,China)
出处
《湖南师范大学学报（医学版）》
2020年第2期52-55,共4页
Journal of Hunan Normal University(Medical Sciences)
关键词
心脏瓣膜病
人工心脏瓣膜置
预后
危险因素
valvular heart disease
prosthetic heart valve replacement
prognosis
risk factors
