风湿性心脏病患者瓣膜置换术术前的临床高危因素分析与探讨

发布时间：2019-05-30 05:35

【摘要】：为了探讨风湿性心脏病患者瓣膜置换术术前的临床高危因素,本研究回顾性收集病历资料完整的风湿性心脏病患者资料110例,按术后是否死亡分为观察组(9例)和对照组(101例),观察组患者术后1个月内死亡,对照组患者手术治疗效果良好,无死亡。以术前一般资料、并发症、合并症、超声心动图及瓣膜病变类型为分析指标,并运用卡方χ~2检验进行术前临床危险因素的单因素分析,对单因素分析得出的术前临床危险因素运用Logistic回归法进行多因素分析。数据表明,病程≥15年、心功能Ⅲ级、ST-T改变、冠状动脉病变、左室舒张末内径≥70 mm、左室后壁厚度≥10 mm以及二尖瓣+主动脉瓣+三尖瓣病变是风湿性心脏病患者瓣膜置换术术前的独立高危因素(p均0.05)。由此可得出,风湿性心脏病瓣膜置换术术前的心功能状态、疾病病程、瓣膜病变类型以及是否有合并冠状动脉系统病变是术后早期致死的高危因素,术前应对这些指标进行明确诊断和积极的围手术期处理,才能确保提升患者术后生存率,本研究为风湿性心脏病患者的临床治疗提供依据。
[Abstract]:In order to investigate the clinical high risk factors of valve replacement in patients with rheumatic heart disease, 110 patients with rheumatic heart disease were collected from 110 patients with rheumatic heart disease. According to the postoperative death, the patients in the observation group (9 cases) and the control group (101 cases) were divided into observation group (n = 9) and control group (n = 101). The patients in the observation group died within 1 month after operation. The preoperative general data, complications, echocardiography and valvular disease types were used as analytical indexes, and chi-square 蠂 ~ 2 test was used to analyze the clinical risk factors before operation. The preoperative clinical risk factors were analyzed by Logistic regression. The data showed that the course of disease 鈮，

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