机械瓣膜置换手术治疗心脏瓣膜病的中远期疗效及围手术期并发症的防治

Medium and Long Term Effect of Mechanical Valve Replacement in Treatment of Cardiac Valvular Disease and Prevention and Treatment of Perioperative Complications

目的探讨机械瓣膜置换手术治疗心脏瓣膜病的中远期疗效探讨及围手术期并发症的防治。方法选取2016年8月至2018年12月常州市武进人民医院收治的88例心脏瓣膜病的患者为研究对象,采用随机数字表法将患者平均分为两组,对照组采用生物瓣膜置换术治疗,观察组采用机械瓣膜置换术治疗。记录两组患者中远期疗效,对比分析两组患者心功能情况,记录两组并发症发生情况。结果两组患者3年存活率比较,差异无统计学意义(P>0.05);观察组患者10年及20年存活率分比别为95.45%及90.91%,明显高于对照组81.82%及72.73%,差异有统计学意义(P<0.05)。观察组患者左室射血分数较对照组高,左心室收缩末期内径及左心室舒张末期内径较对照组低(P<0.05);两组患者并发症发生率比较,差异无统计学意义(P>0.05)。结论针对心脏瓣膜病患者,采用机械瓣膜置换术能更好地改善患者远期心功能,提高患者长期存活率,同时并发症发生率未增加,具有临床推广应用价值。

Objective To explore the mid-and long-term effect of mechanical valve replacement in the treatment of cardiac valvular disease and the prevention and treatment of perioperative complications.Methods A total of 88 cases with cardiac valve disease admitted to our hospital from August 2016 to December 2018 were selected and divided into two groups according to the random number table method,44 cases per group.Patients in the control group received biological valve replacement therapy,and patients in the observation group received mechanical valve replacement.The mid-and long-term curative effects,cardiac function and complications of two groups were compared.Results There was no significant difference in the 3-year survival rate between the two groups(P>0.05).The 10-year and the 20-year survival rates were 95.45%and 90.91%in the observation group,which were significantly higher than 81.82%and 72.73%in the control group(P<0.05).The left ventricular ejection fraction of the observation group was higher than that of the control group,and the inner diameter of the left ventricular end-systolic and end-diastolic end of the left ventricle were lower than that of the control group(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion For patients with cardiac valvular disease,mechanical valve replacement can better improve the long-term cardiac function of patients,improve the long-term survival rate of patients,while the incidence of complications does not increase,which has a clinical application value.