摘要
目的分析主动脉瓣置换术后迟发性三尖瓣反流的危险因素。方法回顾性分析2016年1月至2017年12月因主动脉瓣病变在该院行主动脉瓣置换术的患者104例,收集患者围手术期资料并进行随访,三尖瓣出现中度及以上反流被定义有反流,轻度及以下反流定义为无反流。采用单因素分析和多因素logistic回归分析筛选发生迟发性三尖瓣反流的独立影响因素。结果患者平均随访时间为(6.0±0.7)年,其中39例失访,5例死亡(1例因脑出血死亡、4例因心力衰竭死亡)。主动脉瓣术后迟发性三尖瓣反流的发生率为15.4%。单因素分析显示,心房颤动(70.0%vs.9.1%,P<0.001)及肺动脉压(χ^(2)=9.785,P=0.016)与三尖瓣反流有关;多因素logistic回归分析显示,心房颤动(OR=15.008,P=0.003)是主动脉瓣术后迟发性三尖瓣反流发生的独立危险因素。结论对单纯行主动脉瓣手术的患者应关注心房颤动情况,以预防术后迟发性三尖瓣反流的发生。
Objective To analyze the risk factors for delayed tricuspid regurgitation after aortic valve replacement.Methods A total of 104 cases of aortic valve replacements due to aortic valve lesion in this hospital from January 2016 to December 2017 were retrospectively analyzed.The perioperative data were collected and the follow up was performed.The appearance of moderate or more regurgitation in the tricuspid valve was defined as having regurgitation,and mild and below mild regurgitation was defined as no regurgitation.The independent influencing factors for delayed tricuspid regurgitation were analyzed by using univariate and multivariate logistic regression.Results The average follow-up period was(6.0±0.7)years.There were 39 cases lost the follow-up,5 cases died(1 case died of brain hemorrhage and 4 cases died of heart failure).The incidence rate of delayed tricuspid regurgitation after aortic valve operation was 15.4%.The univariate analysis showed that atrial fibrillation(70.0%vs.9.1%,P<0.001)and pulmonary artery pressure(χ^(2)=9.785,P=0.016)were related with tricuspid regurgitation.The multivariate logistic regression analysis showed that atrial fibrillation(OR=15.008,P=0.003)was the independent risk factor for the delayed tricuspid regurgitation after aortic valve surgery.Conclusion The patients with simple aortic valve surgery should pay attention to the atrial fibrillation situation to prevent the occurrence of delayed postoperative tricuspid regurgitation.
作者
吴纯
许金国
张成鑫
葛圣林
WU Chun;XU Jinguo;ZHANG Chengxin;GE Shenglin(Department of Cardiovascular Surgery,First Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230022,China)
出处
《重庆医学》
CAS
2024年第16期2503-2507,共5页
Chongqing Medical Journal
关键词
主动脉瓣置换术
心房颤动
迟发性三尖瓣反流
危险因素
aortic valve replacement
atrial fibrillation
delayed tricuspid regurgitation
risk factor
