本文關(guān)鍵詞： 心臟瓣膜疾病 二尖瓣置換術(shù) 保留后瓣及其膜下結(jié)構(gòu) 心臟功能　出處：《廣西醫(yī)科大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：總結(jié)比較體外循環(huán)(CPB)心臟停跳下傳統(tǒng)二尖瓣置換術(shù)和保留后瓣膜及其瓣膜下結(jié)構(gòu)二尖瓣置換術(shù)的臨床療效,為探索較好的二尖瓣置換術(shù)術(shù)式提供理論依據(jù)。方法：回顧分析2014年1月1日至2014年12月31日于廣西醫(yī)學(xué)大學(xué)第一附屬醫(yī)院心胸外科住院經(jīng)胸骨中線切口體外循環(huán)心臟停跳下行二尖瓣膜單瓣膜置換術(shù)患者的臨床資料共103例。其中實(shí)驗(yàn)組為保留二尖瓣后瓣膜及其膜下結(jié)構(gòu)二尖瓣單瓣膜置換術(shù)患者47例；對照組為傳統(tǒng)二尖瓣單瓣膜置換術(shù)患者56例。比較兩組手術(shù)時(shí)間、心臟復(fù)跳時(shí)間、術(shù)后機(jī)械通氣時(shí)間及CCU監(jiān)護(hù)時(shí)間等手術(shù)指標(biāo)；心胸比例和Tei指數(shù)、Z指數(shù)、左室舒張末期內(nèi)徑(LVEDD)、左室收縮末期內(nèi)徑(LVESD)、左心室射血分?jǐn)?shù)(LVEF%)與右心室射血分?jǐn)?shù)(RVEF%)等心臟功能指標(biāo)差異。結(jié)果：本研究中,住院期間無患者死亡,所有患者均治愈或好轉(zhuǎn)辦理出院。(1)兩組在手術(shù)時(shí)間、心臟復(fù)跳時(shí)間、術(shù)前心胸比例及術(shù)前各心臟功能指標(biāo)無統(tǒng)計(jì)學(xué)差異(P0.05)；(2)實(shí)驗(yàn)組比對照組術(shù)后機(jī)械通氣時(shí)間和CCU監(jiān)護(hù)時(shí)間分別為(8.4±2.8)h比(9.7±2.4)h和(10.5±4.1)h比(12.7±4.8)h；(3)實(shí)驗(yàn)組及對照組術(shù)后3個(gè)月和6個(gè)月心胸比例分別為0.58±0.21比0.62±0.27和0.51±0.15比0.56±0.20；(4)實(shí)驗(yàn)組及對照組術(shù)后3個(gè)月和6個(gè)月Tei指數(shù)分別為0.82±0.24比0.99±0.34和0.61±0.16比0.7±0.32；Z指數(shù)分別為0.69±0.25比0.45±0.17和0.93±0.34比0.67+0.33；左室舒張末期內(nèi)徑(LVEDD)分別為52.6±6.4mm比56.1±6.9mm和51.1±6.8mm比54.9±7.2mm；左室收縮末期內(nèi)徑(LVESD)分別為41.8±6.9mm比44.7+7.5mm和40.3±-6.5mm比43.1+7.3mm；左心室射血分?jǐn)?shù)(LVEF%)分別為62.3±6.2比56.6±5.7和65.5±7.0比58.3+6.3；右心室射血分?jǐn)?shù)(RVEF%)分別為61.5±7.8比57.7±7.9和64.2±6.9比59.8+7.8。兩組各觀察指標(biāo)均較術(shù)前有明顯改善(P0.05),而實(shí)驗(yàn)組術(shù)后各觀察指標(biāo)均明顯優(yōu)于對照組(P0.05)。結(jié)論：二尖瓣膜置換術(shù)均可明顯改善患者心臟功能,且較傳統(tǒng)二尖瓣單瓣置換術(shù)而言,保留二尖瓣后瓣膜及其瓣膜下結(jié)構(gòu)二尖瓣單瓣置換術(shù)更明顯改善患者術(shù)后心功能,其臨床療效明顯優(yōu)于傳統(tǒng)二尖瓣置換術(shù),為目前我院推廣的二尖瓣單瓣置換術(shù)手術(shù)方式。
[Abstract]:Objective: To summarize the comparison of cardiopulmonary bypass (CPB) cardiac arrest clinical curative effect of the traditional mitral valve replacement and retention after the valve and subvalvular structure of mitral valve replacement, and provide a theoretical basis for the exploration of mitral valve replacement surgery better. Methods: a retrospective analysis from January 1, 2014 to December 31, 2014 in cardiothoracic surgery in the First Affiliated Hospital of Guangxi Medical University clinical data of median sternotomy cardiopulmonary bypass with beating heart mitral valve replacement in patients with single membrane membrane. A total of 103 cases in the experimental group for patients with preserved mitral valve and membrane structure after two tricuspid valve single valve replacement in 47 cases; the control group was 56 patients with mitral valve replacement of traditional single film. Compared the operation time of the two groups cardioversion time, index of operation, postoperative mechanical ventilation time and CCU monitoring time; cardiothoracic ratio and Tei index, Z index, left ventricular end diastolic 鍐呭緞(LVEDD),宸﹀鏀剁緝鏈湡鍐呭緞(LVESD),宸﹀績瀹ゅ皠琛，

本文編號：1492043