老年心脏瓣膜病采用生物瓣膜置换术治疗的临床价值分析

Analysis of clinical value by biological valve replacement in the treatment of senile valvular heart disease

目的探讨生物瓣膜置换术治疗老年心脏瓣膜病的临床效果。方法 42例老年心脏瓣膜病患者,均采用生物瓣膜置换术治疗,分析临床效果。结果所有患者均顺利完成手术,体外循环时间80~134 min,平均体外循环时间（90.2±36.2）min;呼吸机辅助时间12.6~71.0 h,平均呼吸机辅助时间（25.7±15.2）h;主动脉阻断时间38~126 min,平均主动脉阻断时间（51.5±25.4）min;术后住院时间（14.5±3.7）d。术后1例死亡,死于心律失常突发心室颤动;6例患者术后出现肺部感染,经对症治疗后痊愈出院;术后随访12个月,所有患者纽约心脏病协会（NYHA）心功能分级均〉Ⅱ级,均未出现血栓形成、心内膜炎、瓣膜钙化衰败等并发症。含颈动脉狭窄的患者术后清醒时间为（13.1±3.2）h,明显长于含冠状动脉狭窄患者的（8.2±2.4）h,差异具有统计学意义（P〈0.05）。结论老年心脏瓣膜病采用生物瓣膜置换术治疗,能取得较好的应用效果,值得进行深入研究和推广。

Objective To investigate clinical effect by biological valve replacement in the treatment of senile valvular heart disease. Methods A total of 42 senile valvular heart disease patients received biological valve replacement for treatment, and their clinical effects were analyzed. Results All patients received successful operation, with extracorporeal circulation time as 80~134 min and mean extracorporeal circulation time as（90.2±36.2） min; ventilator auxiliary time as 12.6~71.0 h and mean ventilator auxiliary time as（25.7±15.2） h; aorta cross clamp time as 38~126 min and mean aorta cross clamp time as（51.5±25.4） min; postoperative hospital stay time as（14.5±3.7） d. There were 1 death case due to sudden arrhythmia-induced ventricular fibrillation and 6 cases with postoperative pulmonary infection, who were cured by symptomatic treatment. 12-month postoperative follow-up showed all patients with New York heart association（NYHA） cardiac functional classification grade Ⅱ, without any thrombosis, endocarditis, and valvular calcification decline as complications. Patients with carotid artery stenosis had obviously longer postoperative awake time as（13.1±3.2） h than（8.2±2.4） h in patients with coronary artery stenosis, and the difference had statistical significance（P〈0.05）. Conclusion Implement of biological valve replacement provides precise application effect for senile valvular heart disease, and this method is worth further research and promotion.