60～70岁患者二尖瓣机械瓣与生物瓣置换术后疗效的对比观察

发布时间：2018-06-16 12:40

本文选题：心脏瓣膜假体植入 + 预后　；参考：《解放军医学杂志》2017年05期

【摘要】：目的比较分析60~70岁患者行二尖瓣机械瓣置换与生物瓣置换术后瓣膜相关并发症、再次手术率及死亡率的差异。方法回顾性分析2006年1月-至2014年12月在解放军总医院心血管外科行二尖瓣机械瓣置换的119例60~70岁患者及行二尖瓣生物瓣置换的181例同年龄段患者的病例资料,比较两组的手术死亡率、瓣膜相关病死率、并发症发生率及再次手术率的差异。结果机械瓣组患者6年生存率优于生物瓣组(P=0.033),但两组瓣膜相关病死率差异无统计学意义(P=0.277)。机械瓣置换术后并发症包括栓塞10例(8.4%)、出血6例(5.0%),生物瓣置换术后并发症包括栓塞9例(5.0%)、瓣膜结构性毁损4例(2.2%)、瓣膜非结构性功能失常2例(1.1%)、瓣膜血栓5例(2.8%)、出血1例(0.6%)、人工瓣心内膜炎2例(1.1%),总体的并发症发生率两组比较差异无统计学意义(P=0.318)。生物瓣组8年内再次手术3例(1.7%),机械瓣未发生再次手术,但组间比较差异无统计学意义(P=0.305)。结论 60~70岁年龄段患者行二尖瓣机械瓣或生物瓣置换术后6年的瓣膜相关病死率、并发症发生率及再次手术率无明显差异。
[Abstract]:Objective to compare and analyze the difference of mitral valve replacement after mitral valve replacement and biological valve replacement in patients aged 60 ~ 70 years. Methods from January 2006 to December 2014, 119 patients with mechanical mitral valve replacement and 181 patients of the same age who underwent mitral valve replacement in cardiovascular surgery department of PLA General Hospital were retrospectively analyzed. The operative mortality, valvular mortality, complication rate and reoperation rate were compared between the two groups. Results the 6-year survival rate in the mechanical valve group was better than that in the biological valve group, but there was no significant difference in valvular mortality between the two groups. The complications of mechanical valve replacement included embolization in 10 cases, hemorrhage in 6 cases, embolization in 9 cases, structural lesion in 4 cases, nonstructural dysfunction in 2 cases, valvular thrombus in 5 cases and valvular thrombus in 5 cases, the complications of mechanical valve replacement included embolization in 9 cases, valvular structural lesion in 4 cases, valvular nonstructural dysfunction in 2 cases, valve thrombus in 5 cases and valvular thrombus in 5 cases. There was no significant difference in the overall incidence of complications between the two groups. In the biological flap group, there were 3 cases of reoperation within 8 years, but there was no reoperation of the mechanical flap, but there was no significant difference between the two groups (P < 0. 305). Conclusion there is no significant difference in valvular mortality, complication rate and reoperation rate in patients aged 60 to 70 years after mitral valve mechanical valve replacement or biological valve replacement.
【作者单位】：解放军总医院心血管外科;
【分类号】：R654.2

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