心脏机械瓣膜置换278例疗效观察

The effect of prosthetic valves replacement

目的观察心脏机械瓣膜置换术后的中远期疗效。方法收集1997～2007年10年间我院行人工机械瓣膜置换术278例,同期随访225例。观察术后患者心脏功能改善、并发症以及生存情况。结果随访225例中,5年生存率(92.2±2.2)%,10年生存率(90.2±2.7)%,12例死亡。发生并发症有机械瓣膜功能障碍、瓣周漏、溶血、栓塞、感染性心内膜炎发生。术后心功能与术前比较有明显提高。结论机械瓣膜置换术后中远期疗效满意;保留二尖瓣下结构、三尖瓣形成术对术后恢复效果明显;加强无菌操作,减少补救时间,降低心内感染机会;术中心肌保护提高手术成功率。

Objective To explore the mid-long-term results of prosthetic valves replacement.Methods 278 patients underwent prosthetic valves replacement from 1997 to 2007 were collected and 225 patients were followed up.The heart function,complications and survival rates were observed after surgery.The data were analyzed by T test.Results The 5-year and 10-year survival rates were respectively（92.2±2.2）% and （90.2±2.7）% and 12 patients died after operation.The main complications were valve mechanical malfunction,peri-prosthetic leak,hemolysis,thromboembolism and infective endocarditis.The heart function was significantly improved after valves replacement.Conclusion The mid-long-term results of prosthetic valves replacement are rather satisfactory.Subvalvular structure preservation and tricuspid annuloplasty can greatly improve heart function.Sterile operation is necessary and it can reduce heart infection.Satisfactory myocardial protection is the key of successful operation.