生物瓣膜与机械瓣膜治疗老年心脏瓣膜病患者的效果比较

Comparison of effects of biological valve and mechanical valve in treatment of elderly patients with valvular heart disease

目的:比较生物瓣膜与机械瓣膜治疗老年心脏瓣膜病患者的效果。方法:选取80例老年心脏瓣膜病患者作为研究对象,依据随机数字表法将其分为对照组和观察组各40例,对照组采用机械瓣膜置换治疗,观察组采用生物瓣膜置换治疗,比较两组手术相关情况、心脏彩超结果、手术前后心功能分级情况及并发症的发生情况。结果:观察组住院时间明显短于对照组,差异有统计学意义(P<0.05);手术前后两组心室射血分数(EF)、左心房大小(LA)、左室收缩末期内径(LVEDD)水平比较,差异无统计学意义(P>0.05),术后两组EF、LA及LVEDD水平均明显优于术前,差异有统计学意义(P<0.05);治疗后随访12个月,观察组心功能分级情况明显优于对照组,差异有统计学意义(P<0.05);观察组的并发症发生率为5.0%(2/40),明显低于对照组的27.5%(11/40),差异有统计学意义(P<0.05)。结论:与机械瓣膜置换术相比,生物瓣膜置换术治疗老年心脏瓣膜病患者的效果更显著,可促进患者术后恢复,明显改善患者的心功能,且安全性更高。

Objective:To compare effects of biological valve and mechanical valve in treatment of elderly patients with valvular heart disease.Methods:80 elderly patients with valvular heart disease were selected as the study subjects.They were divided into control group(n=40)and observation group(n=40)according to the random number table method.The control group was treated with mechanical valve replacement,while the observation group was treated with bioprosthetic valve replacement.The operation status,cardiac ultrasound results,cardiac function grading and complications before and after the surgery were compared between the two groups.Results:The hospital stay in the observation group was significantly shorter than that in the control group,and the difference was statistically significant(P<0.05).There were no significant differences in the ventricular ejection fraction(EF),left atrial size(LA),and left ventricular end-systolic diameter(LVEDD)between the two groups before and after the surgery(P>0.05).The levels of EF,LA and LVEDD in the two groups after the surgery were significantly better than those before the surgery,and the difference was statistically significant(P<0.05).After 12 month-follow-up,the cardiac function grading of the observation group was significantly better than that of the control group,and the difference was statistically significant(P<0.05).Further,the complication rate of the observation group was 5.0%(2/40),which was significantly lower than that of the control group(27.5%,11/40),and the difference was statistically significant(P<0.05).Conclusions:Compared with mechanical valve replacement,bioprosthetic valve replacement is more effective in the treatment of elderly patients with valvular heart disease.It can promote the postoperative recovery and significantly improve the patients’cardiac function with higher safety.