巨大左心室心瓣膜置换术后近中期的疗效以及危险因素分析

发布时间：2019-03-07 12:58

【摘要】：目的观察巨大左心室患者行心脏瓣膜置换手术后近中期的手术疗效以及探讨影响其预后的相关危险因素。方法回顾性分析82例心瓣膜病合并巨大左心室患者行心瓣膜置换术的临床资料,比较术前术后近中期的心脏大小以及心脏功能的改变,并探讨影响其预后的相关危险因素。结果术后近中期左心房内径、左心室舒张期末内径、左心室收缩期内径(LVESD)均较术前减小,差异有统计学意义(P0.05),而术后左心室射血分数值、左心室缩短率值与术前比较差异无统计学意义,术后心功能分级(NYHA)与术前比较差异有统计学意义(P0.05);影响患者预后的相关危险因素有术前LVESD值≥6.0 cm、心功能NYHA分级在Ⅳ级、术后未使用血管紧张素转化酶抑制剂(ACEI)类药物或者β-受体阻滞剂(P0.05)。结论心瓣膜病合并巨大左心室患者行心瓣膜置换术后围手术期死亡率低,且术后近中期心脏的形态大小发生了明显的逆重构过程,心功能同样明显改善,手术疗效满意。心功能Ⅳ级、LVESD≥6.0 cm、术后未使用小剂量的ACEI类药物或β-受体阻滞剂是影响预后的主要危险因素。
[Abstract]:Objective to observe the curative effect of cardiac valve replacement in patients with giant left ventricle and explore the risk factors affecting its prognosis. Methods the clinical data of 82 patients with valvular heart disease complicated with giant left ventricle were retrospectively analyzed. The changes of heart size and cardiac function were compared before and after operation, and the risk factors affecting the prognosis were also discussed. Results the left atrium diameter, left ventricular end diastolic diameter and left ventricular systolic diameter (LVESD) decreased significantly (P0.05), but left ventricular ejection fraction (LVEF) after operation was significantly lower than that before operation (P0.05), but left ventricular ejection fraction (LVEF) after operation was significantly lower than that before operation (P0.05). There was no significant difference in left ventricular shortening rate between pre-operation and left ventricular shortening rate, but there was significant difference between postoperative cardiac function grading (NYHA) and pre-operation (P0.05). The risk factors influencing the prognosis of the patients were pre-operation LVESD 鈮，

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