| 张正升,郭立燕,张申,韩贵芝,吴联合,盛存见.心脏瓣膜病术后临床结局相关因素分析[J].济宁医学院学报,2019,42(4):253-256 |
| 心脏瓣膜病术后临床结局相关因素分析 |
| Analysis of the related factors of clinical efficacy after cardiac valve surgery |
| 投稿时间：2019-05-14 |
| DOI：10.3969/j.issn.1000-9760.2019.04.006 |
| 中文关键词: 心脏瓣膜病;心瓣膜置换术;危险因素;临床结局 |
| 英文关键词: Valvular heart disease;Death;Cardiac valve replacement;Clinical outcomes;Risk factor |
| 基金项目:山东省医药卫生科技发展计划项目（2017WS650）；济宁医学院校级科研扶持基金（JY2017KJ006）。 |
| 作者 | 单位 | E-mail | | 张正升 | 济宁医学院附属济宁市第一人民医院, 济宁 272011 | | | 郭立燕 | 济宁医学院公共卫生学院, 济宁 272013 | | | 张申 | 济宁医学院附属济宁市第一人民医院, 济宁 272011 | zhangshen138@163.com | | 韩贵芝 | 济宁医学院公共卫生学院, 济宁 272013 | | | 吴联合 | 济宁医学院附属济宁市第一人民医院, 济宁 272011 | | | 盛存见 | 济宁医学院附属济宁市第一人民医院, 济宁 272011 | |
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| 中文摘要: |
| 目的 研究心脏瓣膜病外科治疗效果的现状及术后的危险因素，为加强患者健康有效的术后护理，提高临床治疗技术和患者生命质量提供理论依据。方法 回顾性分析济宁医学院附属济宁市第一人民医院2016年1月至2017年1月确诊为心脏瓣病的患者临床资料，对术后结局的相关因素进行统计学分析。结果 207例患者中住院死亡10例，死亡率4.8%，并发症127例，发生率61.4%。心脏瓣膜病患者术后住院早期死亡的相关因素（OR及其95%CI）有：年龄>45岁（14.421，1.992~104.276），二尖瓣合并肺动脉瓣异常（34.953，2.236~546.260），心功能分级（NYHA）Ⅲ级和Ⅳ级（22.204，1.686~292.511），心肌梗死（6.981，1.428~34.129）。术后室性心律失常的相关因素（OR及其95%CI）有：LVEDD>50mm（1.943，1.014~3.726），同期行三尖瓣成形术（3.882，1.912~7.881）。结论 年龄>45岁，心功能（NYHA）Ⅲ级和Ⅳ级，心肌梗死，二尖瓣合并肺主动脉瓣病变是心脏瓣膜患者住院早期死亡的危险因素；LVEDD>50mm，同期行三尖瓣成形术，是术后室性心律失常的危险因素。 |
| 英文摘要: |
| Objective To study the effect of surgical treatment of valvular heart disease and its risk factors,and provide a theoretical basis for the improvement of the patient's health and effective postoperative care,and improve the clinical treatment technology and the quality of life of patients. Methods The clinical data of patients with valvular heart disease diagnosed in Jining NO.1 People's Hospital from January 2016 to January 2017 were retrospectively analyzed. Results 207 patients died in hospital and the mortality rate was 4.8%.The complications occurred in 127 cases with a rate of about 61.4%.The related factors of early death in patients with valvular heart disease (OR and 95% CI) were older than 45 years old (14.412,1.992~104.276),mitral and pulmonary valve abnormal heart function classification (34.953,2.236~546.260), (NYHA) Ⅲ and Ⅳ (22.204,1.686~292.511),myocardial infarction (6.981,1.428~34.129).The related factors of postoperative ventricular arrhythmias (OR and 95% CI) were as following:LVEDD>50mm (1.943,1.014~3.726),three point tricuspid valvuloplasty (3.882,1.912~7.881). Conclusion Older than 45 years old,heart function (NYHA) of Ⅲ and Ⅳ,myocardial infarction,mitral and aortic and pulmonary lesions are the risk factors of early death in patients with cardiac valve disease.LVEDD>50mm and the same period of three tricuspid valvuloplasty are risk factors for postoperative ventricular arrhythmias after the operation. |
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