体外循环下左室瓣膜置换术的临床疗效研究

The clinical effect of left ventricular valve replacement under cardiopulmonary bypass

目的探讨体外循环下左室瓣膜置换术的临床疗效。方法选择本院行左室瓣膜置换术的170例大左心室瓣膜病患者为研究对象,观察患者术后早期死亡和并发症发生情况以及治疗前后的超声心动图指标和心功能分级。结果患者行体外循环下左室瓣膜置换术术后死亡率为5.29%(9/170)。与治疗前相比,患者治疗后LVEDD、TRPG明显降低,LVEF、LVFS明显升高,差异均有统计学意义(均P<0.05);治疗后NYHA III级、IV级患者明显减少,NYHA I级、II级患者明显增多,差异均有统计学意义(均P<0.05)。结论大左心室瓣膜病患者行体外循环下左室瓣膜置换术的近期疗效满意,围术期死亡率低,且术后左室重构、心功能明显改善。

Objective To investigate the clinical efficacy of left ventricular valve replacement under cardiopulmonary bypass.Methods A total of 170 patients with large left ventricular valvular disease who underwent left ventricular valve replacement in our hospital were selected as research objects.The patients'early postoperative mortality and complications were observed,as well as the echocardiographic indexes and cardiac function grading before and after treatment.Results The postoperative mortality rate of patients with left ventricular valve replacement under cardiopulmonary bypass was 5.29%(9/170).Compared with those before treatment,LVEDD and TRPG significantly reduced after treatment,and LVEF and LVFS significantly increased,with statistically significant differences(all P<0.05);the number of NYHA degree III and IV patients decreased significantly after treatment,the number of NYHA degree I and II patients increased significantly,with statistically significant differences(all P<0.05).Conclusion Left ventricular valve replacement under cardiopulmonary bypass has satisfactory short-term results in patients with large left ventricular valvular disease,and low perioperative mortality rate,which can significantly improve left ventricular remodeling and cardiac function after surgery.