冠状动脉旁路移植同期行心脏瓣膜置换术治疗冠心病合并心脏瓣膜病的临床观察

Clinical observation of coronary artery bypass grafts in the same period of heart valve replacement on the treatment of coronary heart disease with heart valve disease

目的:为了进一步提高冠心病合并心脏瓣膜病患者的治疗效果并减少各种不良事件的发生率,分析和探讨在治疗过程中选取冠状动脉旁路移植同期行心脏瓣膜置换术的价值和意义。方法:按照随机数字表的方法选取60例于2013年2月至2015年2月来我院治疗的冠心病合并心脏瓣膜病患者作为研究对象并依据双盲对照的原则将其分为试验组和对照组各30例,其中试验组患者在治疗方案上选取冠状动脉旁路移植同期行心脏瓣膜置换术治疗,而对照组患者在治疗方案上选取冠状动脉旁路移植非同期行心脏瓣膜置换术治疗,比较不同方案的疗效差异以及术后对心功能的影响。结果:经过统计分析发现,对照组患者各项观察指标和试验组相比明显增加,且两组比较差异具有统计学意义(P<0.05);试验组患者术后各心功能指标和对照组患者相比都显著好转,且两组比较差异具有统计学意义(P<0.05)。结论:冠心病合并心脏瓣膜病患者在治疗的过程中可以同时采取心脏瓣膜手术联合冠状动脉旁路手术治疗。通过术前和术后对症处理,术中保护好心肌,能够有效的预防和减少手术的各种并发症的发生,值得临床推广应用。

Objective To analyze and discuss the value and significance of coronary artery bypass grafts in the same period of heart valve replacement in the process of the coronary heart disease with heart valve disease treatment, in order to improve the effect of treatment and reduce the incidence of adverse events. Methods 60 cases with coronary heart disease with heart valve disease, which admitted in our hospital during February 2013-February 2015, were selected as the research objectaccording to random number table method and divided into theexperimental group and the control group, each group of 30 cases according to the principle of double blind control.The experimental group was given the coronary artery bypass grafts in the same period of heart valve replacement and the control group was given the coronary artery bypass grafts without heart valve replacement. The curative effects of different schemes and effects on cardiac function after surgery of the two groups were compared. Results After statistical analysis found thatthe observation indexes of the control group was significantly increased compared with the experimental group, the difference was significant statistically significant（P 0.05）. The postoperativecardiac function indexes of the experimental group was significantly improved then control group, the difference was significant statistically significant（P 0.05）. Conclusion Coronary heart disease with heart valve disease in the process of treatment can also take heart valve surgery combined coronary artery bypass surgery. By preoperative and postoperative symptomatic treatment, intraoperative protect myocardium, can effectively prevent and reduce the operation of various complications, which is worthy of clinical popularization and application.