文章摘要
米怀雪,张申.同期行心脏瓣膜术与冠状动脉旁路移植术治疗心脏瓣膜病合并中度冠脉病变临床疗效观察[J].济宁医学院学报,2019,42(4):249-252
同期行心脏瓣膜术与冠状动脉旁路移植术治疗心脏瓣膜病合并中度冠脉病变临床疗效观察
Experience of simultaneous heart valve surgery and coronary artery bypass grafting in patients undergoing heart valve surgery with moderate coronary heart disease
投稿时间:2019-06-10  
DOI:10.3969/j.issn.1000-9760.2019.04.005
中文关键词: 心脏瓣膜手术;冠脉搭桥术;同期手术;临床疗效
英文关键词: Heart valve surgery;Coronary artery bypass grafting;Simultaneousoperation;Therapeutic effect
基金项目:
作者单位E-mail
米怀雪 济宁医学院附属济宁市第一人民医院, 济宁 272011  
张申 济宁医学院附属济宁市第一人民医院, 济宁 272011 zhangshen138@sina.com 
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中文摘要:
      目的 总结同期实施心脏瓣膜术、冠状动脉旁路移植术治疗心脏瓣膜病合并中度冠脉病变的临床疗效。方法 选取2013年1月-2017年3月于我院手术治疗的心脏瓣膜病合并中度冠脉病变156例患者,依据随机对照原则分为同期组(78人)和对照组(78人),同期组患者同期实施心脏瓣膜手术、冠状动脉旁路移植术,对照组患者仅实施心脏瓣膜手术。术中均采用HTK心肌灌注、改良超滤,比较两组术后临床参数,分析临床疗效。结果 同期组患者体外循环转机时间、主动脉阻断时间长于对照组(P<0.05),而同期组患者呼吸机插管时间、心外科ICU监护时间和术后普通病房住院时间短于对照组(P<0.05);同期组患者术后6个月心胸比、BNP、左心房内径、左室射血分数优于对照组(P<0.05),同时该组患者术后12月内主要心血管不良事件低于对照组(P<0.05)。结论 对于合并中度冠脉病变的心脏瓣膜病患者,同期行心脏瓣膜手术、冠状动脉旁路移植术,可行性强,临床疗效值得肯定。
英文摘要:
      Objective To summarize the clinical efficacy of simultaneous heart valve surgery and coronary artery bypass surgery in patients undergoing heart valve surgery with moderate coronary artery disease. Methods The 156 cases of heart valvular disease combined with coronary heart disease in our hospital from January 2013 to March 2017 were selected.Based on the randomized control principle,they were divided into the same period group (78 people) and the control group (78 people).HTK myocardial perfusion and modified ultrafiltration were used in the operation.The clinical parameters of the two groups were compared,and the clinical efficacy was analyzed. Results The time of cardiopulmonary bypass and aortainterruption were longer in the same period group than that the control group (P<0.05).The time of ventilator intubation,ICU monitoring in the heart surgery andhospitalization in the general ward were shorter in the same period than the control group (P<0.05).The cardiopulmonary bypass,BNP,the left atrium and the left ventricular ejection points was better in the same period than the control group (P<0.05).The major adverse cardiovascular events in the patients within 12 months after surgery (Acute heart failure,atrial fibrillation,intractable myocardial ischemia) were lower than in the same period than the control group (P<0.05). Conclusion For patients undergoing heart valve surgery with moderate coronary disease,the simultaneous heart valve surgery and coronary artery bypass grafting surgery is feasible,and the clinical effect is worthy of affirmation.
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