心脏机械瓣膜置换手术前后生活质量的对比研究

Comparative study of quality of life before and after mechanical heart valve replacement

目的 针对我国瓣膜病人的特点 ,对比研究换瓣手术前后生活质量变化。方法 1998年2月至 6月对 115例人工心脏机械瓣膜置换病人进行手术前后生活质量变化的对比研究。结果 换瓣手术后病人体力活动能力较手术前明显改善 ,尤其户外活动能力较手术前明显改善 ,日常生活能力增强。手术后 84 %病人恢复患病前的心情 ,其术后的孤独、压抑、焦虑和紧张评分较术前明显减低 ,性生活和脾气急躁较术前也明显改善。术后病人的家庭生活、社会关系及工作生活等方面较术前明显改善(P =0 0 0 0 )。 6 4 %有瓣膜相关损害的病人认为在当地购买抗凝药物不方便 ,而无并发症病人仅为 39% ,两组有明显差异 (P =0 0 34) ;担心服用抗凝药物导致出血方面 ,有并发症病人肯定回答显著高于无并发症病人 (86 %对 5 5 % ,P =0 0 0 6 )。结论 人工心脏机械瓣膜置换手术可显著改善心脏瓣膜病病人生活质量。应降低人工瓣膜相关并发症发生率。

Objective: To compare the quality of life before and after artificial mechanical heart valve replacement. Methods: From February to June 1998, 115 patients (56 males, 59 females) underwent mechanical valve replacement. The investigation table was filled in one week before the operation and three months postoperatively. Results: There was a notable improvement in patient's physical strength, activity ability, emotion aspect and society home life after operation (P=0.000). In patients with valve-related complications, 64% complained inconvenience in purchasing anticoagulant medicines in the locality, while in patients without valve-related complications, only 39% have such experience. There was significant difference between two groups (P=0.034). 86% of patients with complications worry about the possibility bleeding, while in those with no complications only 55% (P=0.006). Conclusion: Mechanical prosthetic valve replacement significantly improves patient's physical strength, activity ability, emotion and society-home life.