心脏瓣膜病机械瓣膜置换术后疗效的随访研究

Follow-up studies of valvular heart disease efficacy of mechanical valve replacement surgery

目的研究心脏瓣膜病机械瓣膜置换术的疗效。方法选取125例心脏瓣膜病患者,根据所置换人工瓣膜的类型分为两组:A组85例应用机械瓣膜置换,B组40例应用生物瓣膜置换。比较两组的疗效,随访预后情况。结果 A组围术期死亡率差异无统计学意义(P>0.05);两组术后心功能较术前均显著改善,A组术后心功能优于B组。A组瓣周漏、血栓栓塞、人工瓣膜性心内膜炎的发生率均低于B组(P均<0.05)。结论机械心脏瓣膜置换术治疗心脏瓣膜病疗效确切,心功能改善明显,术后存活率高。选择合理的手术时机、术中良好的心肌保护及有效的术后抗凝是减少并发症的关键。

Objective To explore the efficacy of mechanical valve replacement valve. Methods Selected 125 cases of heart valve disease, prosthetic valve type were divided into two groups ： A group of 85 cases of application of mechanical valve replacement, B group of 40 patients were treated with biological valve replacement. Compared the efficacy of two follow-up prognosis. Results A group of perioperative mortality difference was not statistically significant （P〉 0.05） ; were significantly improved compared with the preoperative postoperative cardiac function, A group of cardiac function was better than group B.A group of paravalvular leakage, thromboembolism,prosthetic valve endocarditis occurred were lower than group B （P 〈0.05）. Conclusion Mechanical heart valve replacement surgery is effective for heart valve disease, heart function improved significantly, postoperative survival rate is high. Reasonable choice of timing of surgery, intraoperative myocardial protection and good postoperative antieoagulation is effective to reduce the critical complications.