急诊手术治疗危重心脏瓣膜病效果观察及对患者心功能的影响

The therapeutic effect of emergency surgery in the treatment of severe valvular heart disease and its influence on heart function

目的 观察危重心脏瓣膜病急诊外科效果及对心功能影响.方法 选择87例危重心脏瓣膜病患者为研究对象,均予以急诊手术治疗,比较治疗前后心脏功能指标[左室舒张末容积（EDV）、左室收缩末容积（ESV）、左室收缩末期容量指数（LVESVI）、左室舒张末容量指数（LVEDVI）、左室射血分数（LVEF）],术后并发症及生存率.结果 治疗后患者EDV（125.78 ±31.67）mL、ESV（71.30±16.58）mL、LVESVI （50.39±13.30） mL/m2、（88.74±13.51） mL/m2、（51.48±12.73）％优于治疗前的（116.48±28.94） mL、（63.26±15.47）mL、（33.27±8.54） mL/m2、（64.47±12.69） mL/m2、（47.53±11.20）％,差异均有统计学意义（t=2.022、3.307、10.103、12.213、2.173,均P＜0.05）;有21例发生并发症,其中心律失常4例,低心排出量综合征8例,急性肾功能衰竭9例;术后1年、2年生存率分别是91.95％ （80/87）和85.06％ （74/87）.结论 危重心脏瓣膜病患者急诊手术治疗能够有效改善心脏功能指标,提高生存率,值得进一步推广应用.

Objective To analyze the therapeutic effect of emergency surgery in the treatment of severe valvular heart disease and its influence on heart function.Methods 87 cases with severe valvular heart disease were selected,and they were given emergency surgical treatment.Before and after treatment,the cardiac function index[end -diastolic volume （EDV）,end-systolic volume （ESV）,left ventricular end systolic volume index （LVESVI）,left ventricular end-diastolic volume index （LVEDVI）,left ventricular ejection fraction （LVEF）],postoperative complications and survival rate were compared.Results After treatment,the EDV [（125.78 ± 31.67） mL],ESV [（71.30 ± 16.58） mL] and LVESVI [（50.39 ± 13.30） mL/m2],LVEDVI [（88.74 ± 13.51） mL/m2],LVEF [（51.48 ± 12.73） %] were better than those before treatment [（116.48 ± 28.94） mL,（63.26 ± 15.47） mL,（33.27 ± 8.54） mL/m2,（64.47 ± 12.69）mL/m2,（47.53 ± 11.20）%],the differences were statistically significant （t =2.022,2.022,3.307,12.213,2.173,all P 〈 0.05）.The incidence rate of complications was 24.14% （21/87）,included arrhythmia in 4 cases,low cardiac output syndrome in 8 cases,acute renal failure in 9 cases.Postoperative 1 year,2 years,the survival rates were 91.95% （80/87）,85.06% （74/87）,respectively.Conclusion Emergency surgical treatment for severe valvular heart disease can effectively improve cardiac function index,improve the survival rate.