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人工瓣-患者体形比例对主动脉瓣置换术后功能恢复的影响
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作者 Koch C. g. Khandwala f. +1 位作者 estafanous f. g. 贺永明 《世界核心医学期刊文摘(心脏病学分册)》 2005年第11期37-38,共2页
Background-Prosthesis-patient size mismatch results when an implanted prosthetic aortic valve is of insufficient size for a patient’s body surface area. The relation between prosthesis-patient size and functional cap... Background-Prosthesis-patient size mismatch results when an implanted prosthetic aortic valve is of insufficient size for a patient’s body surface area. The relation between prosthesis-patient size and functional capacity and adverse postoperative outcome is inconsistent. Our objectives were to examine the impact of valve replacement,continuous prosthesis-patient size, and other factors on functional recovery after aortic valve replacement(AVR) with the Duke Activity Status Index(DASI). Methods and Results-From June 15, 1995, through May 14, 1998, 1108 patients underwent AVR after completing a DASI survey. Of these, 1014 completed a postoperative DASI survey at an average of 8.3 months postoperatively. Logistic ordinal regression was used to examine the influence of demographic variables, comorbidities, baseline DASI scores, indexed valve orifice area, standardized orifice size, and postoperative morbid events on postoperative DASI. There was overall improvement in postoperative functional recovery reflected by median preoperative and postoperative DASI scores of 29 and 46, P< 0.001, respectively. Neither indexed orifice area, P=0.94, nor standardized orifice size, P=0.96, was associated with functional recovery. Female sex, increasing age, elevated serum creatinine, increased central venous pressure, and red blood cell transfusion were factors associated with poor postoperative functional recovery. Conclusions-A majority of patients report improvement in functional quality of life early after AVR. Similar functional recovery was demonstrated for patients along the full spectrum of valve sizes indexed to body size, even for values considered to represent severe mismatch for patient size. Factors other than prosthesis-patient size influence functional quality of life early after AVR. 展开更多
关键词 主动脉瓣置换术 患者体形 功能恢复 瓣口面积指数 瓣膜置换术 体表面积 回归分析研究 人口统计学 中心静脉压 活动状态
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