生物瓣膜置换术治疗老年心脏瓣膜病的安全性及疗效

Safety and efficacy of application of biological valve replacement in the treatment of elderly patients with valvular heart disease

目的分析生物瓣膜置换术治疗老年心脏瓣膜病的安全性及疗效。方法选取2010年1月-2015年1月我院收治的60例老年心脏瓣膜病患者,根据所置换人工瓣膜类型分为两组,对照组30例应用机械瓣膜置换,研究组30例应用生物瓣膜置换,对两组患者临床效果进行比较,分析生物瓣膜置换术治疗疾病的安全性与疗效。结果对老年心脏瓣膜病患者应用生物瓣膜置换术可以发挥重要疗效,安全性高,可显著缩短手术时间与住院治疗时间,研究组分别为（80±25）min和（8±1.2）d,对照组分别为（120±19）min和（10±2.4）d,组间差异有统计学意义（均P〈0.05）;研究组经生物瓣膜置换术治疗后临床疗效（86.7%）明显高于对照组（56.7%）,组间差异有统计意义（P〈0.05）。研究组随访中远期并发症发生率为瓣周漏（0.0%）、血栓栓塞（3.3%）、心内膜炎（0.0%）,较对照组瓣周漏（6.7%）、血栓栓塞（10.0%）、心内膜炎（6.7%）均高,差异有统计学意义（均P〈0.05）,但研究组出血发生率（13.3%）与对照组（13.3%）比较不存在差异（P〉0.05）。结论在临床老年心脏瓣膜病治疗中,应用生物瓣膜置换术,效果要好于机械瓣膜置换术,可降低手术不良反应发生几率,安全性高,发挥了积极的治疗效果,可在临床中推广。

Objective To analyze the safety and efficacy of the treatment of senile heart valve disease by biological valve replacement.Methods 60 elderly patients with heart valve disease were divided into two groups according to the type of valve replacement.30 cases in the control group were treated with mechanical valve replacement.30 cases in the study group were compared with the clinical effect of the two groups.The safety and efficacy of the treatment of the disease were analyzed.Results Biological valve replacement in the treatment of senile heart valve disease can play an important curative effect,high safety,significantly shorten the operation time and hospitalization time.The operation time and hospitalization time of research group were（80±25）min and（8±1.2）d.The operation time and hospitalization time of control group were（120±19）min and（10±2.4）d.The two groups were significantly different（P〈0.05）.The clinical efficacy of the study group（86.7%）was significantly higher than that of the control group（56.7%）.The difference between the two groups（P〈0.05）.In the study group,the incidence of long-term complications was 0（6.7%）,thrombosis（3.3%）,endocarditis（0）,compared with the control group（10%）.The difference was P〈0.05（6.7%）.The bleeding incidence（13.3%）was not different from the control group（P〉0.05）.Conclusion In the clinical treatment of heart valve disease,the effect of application of biological valve replacement is better than that of mechanical valve replacement.biological valve replacement can reduce the incidence of adverse reactions and increase security.