心脏术后继发性三尖瓣关闭不全再次行三尖瓣置换术的危险因素分析

发布时间：2019-06-09 18:16

【摘要】：目的:回顾性分析心脏术后三尖瓣关闭不全行三尖瓣置换术死亡危险因素,评价New EuroSCOREⅡ对三尖瓣置换术后风险的预测作用。方法:回顾性分析77例心脏术后再次行三尖瓣置换术病例的临床资料,将临床资料分为死亡组与存活组,对入选者的临床资料进行单因素统计分析,变量资料计算各组平均数±标准差,并对分组资料行t检验,计算P值,变数资料计算各组频数及构成比,并对分组资料行卡方检验,计算P值。将单因素统计分析结果有统计学意义(P0.05)的因素带入Logistic回归模型,分析术前及术中多种因素对心脏术后行三尖瓣置换术后死亡的影响。分别计算死亡组与非死亡组New Euro SCOREⅡ评分的平均数±标准差,对两组资料行t检验,并计算P值。结果:77例患者中术后早期在院死亡8例,死亡率10.4%。单因素分析显示术前NYHAⅣ级、右心衰、肺动脉压力(58mm Hg)、总胆红素(50umol/L)、肌酐(90 umol/L)、尿素(12mmol/L)、尿酸(560 umol/L)、无心房颤动与术后早期死亡有显著性意义(P0.05),术中体外循环时间(200min)、心肌保护液(2500m L)、升主动脉阻断时间(80min)及置换瓣膜过小与术后早期死亡有统计学意义(P0.05)。多因素Logistic回归模型分析表明术前肌酐(90 umol/L)、无心房颤动是心脏术后再次行三尖瓣置换术早期病人死亡的独立危险因素(P0.05)。统计结果显示死亡组与非死亡组Euroscore评分的差异有统计学意义。结论:心脏术后远期因三尖瓣关闭不全行三尖瓣置换有诸多危险因素与术后早期死亡有关,术前要特别注意对肾功能异常和无心房颤动患者的准备工作,New Euro SCOREⅡ可以作为预测此类手术风险的可靠评分系统。
[Abstract]:Objective: to analyze the risk factors of tricuspid valve replacement for tricuspid valve insufficiency after cardiac surgery and to evaluate the predictive effect of New EuroSCORE II on the risk of tricuspid valve replacement. Methods: the clinical data of 77 patients undergoing tricuspid valve replacement after cardiac surgery were analyzed retrospectively. the clinical data were divided into death group and survival group. The mean 卤standard deviation of each group was calculated by variable data, t test was performed on the grouped data, P value was calculated, the frequency and composition ratio of each group were calculated by variable data, and chi-square test was performed to calculate the P value of the grouped data. The factors with statistical significance (P 0.05) were brought into the Logistic regression model to analyze the effects of various factors on the death after tricuspid valve replacement before and during cardiac surgery. The average 卤standard deviation of New Euro SCORE 鈪，

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