80岁以上老年患者心脏手术77例临床分析

Outcomes results of 77 cases cardiac surgery in patients age≥80 years

目的:对80岁以上患者心脏手术结果资料进行临床分析,评价临床选择标准和手术疗效。方法:2002年7月至2009年5月接受心脏手术的≥80岁患者77例,其中瓣膜病7例,冠心病65例,先天性心脏病1例,大血管病等4例。结果:66例患者手术后痊愈出院,治愈率85.7%。手术死亡11例,全部为冠心病行冠状动脉旁路移植手术患者,病死率为14.3%,其中男性9例,女性2例。死亡原因为心力衰竭(心衰)7例,呼吸衰竭3例,大出血1例。重症监护室时间为(3.5±3.3)d,住院时间为(25.1±13.1)d。并发症发生率为32.5%。结论:虽然80岁以上心脏手术并发症发生率高,住院时间长,手术死亡率高,但是手术使患者摆脱心脏疾病症状,80岁以上老年患者进行心脏手术是可行的。

Objective：Today,the elderly population continues to increase worldwide,the number of patients undergoing cardiac surgery is expected to grow.To evaluate the efficiency and safety in the patients age ≥80 years with cardiac disease who underwent cardiac surgery,we analyzed the patients clinical results information.Expanding demand for cardiac surgery in the elderly requires constant assessment of selection criteria and outcomes.Methods：Retrospectively analysis the information of 77 cases patients who underwent cardiac surgery procedures between September 2002 and May 2009.77 cases were retrospectively reviewed（61 male,16 female）.There were 65 coronary bypass grafting（CABG）,7 valve,5 other procedures.The mean age was 81.5 and 83.5 years in the male and female patient groups,respectively.The number of deaths and causes of death,as well as operation-related complications,were noted.Results：The operation procedures of 66 patients were successful without any complication。The 30 day mortality rates were 14.3% in the patient age ≥80 years.Eleven（14.3%） deaths occurred during the index hospital stay.All dead patients were operated with coronary artery diseases.Nine of patients were male,two of patients were female.It is because of 7 heart failure,3 respiratory failure,1 great bleeding.Intensive care unit and hospital length of stay lasted（3.5 ± 3.3） days and（25.1 ± 13.1） days,respectively.Operative complications were 32.5% patients.Postoperative complication such as myocardial infarction,cardiac failure requiring intraaortic balloon pumping,acute renal failure requiring replacement therapy,stroke,and ventilator dependency exceeding 48 hours.Conclusion：Survival of patients age≥80 years submitted to a wide variety of cardiac operations was satisfactory despite substantial rates of early complications and deaths.Cardiac operations with or without cardiopulmonary bypass provided acceptable surgical results,we achieved the same aim to get rid of clinical symptoms.Octogenarians especially had a good life expectancy,possibly due to their low comorbidity rates.Hence,Cardiac operations proved to be an excellent treatment in patients age≥80 years.