本文選題：心臟瓣膜假體植入 + 預(yù)后　； 參考：《解放軍醫(yī)學(xué)雜志》2017年05期

【摘要】：目的比較分析60~70歲患者行二尖瓣機(jī)械瓣置換與生物瓣置換術(shù)后瓣膜相關(guān)并發(fā)癥、再次手術(shù)率及死亡率的差異。方法回顧性分析2006年1月-至2014年12月在解放軍總醫(yī)院心血管外科行二尖瓣機(jī)械瓣置換的119例60~70歲患者及行二尖瓣生物瓣置換的181例同年齡段患者的病例資料,比較兩組的手術(shù)死亡率、瓣膜相關(guān)病死率、并發(fā)癥發(fā)生率及再次手術(shù)率的差異。結(jié)果機(jī)械瓣組患者6年生存率優(yōu)于生物瓣組(P=0.033),但兩組瓣膜相關(guān)病死率差異無統(tǒng)計(jì)學(xué)意義(P=0.277)。機(jī)械瓣置換術(shù)后并發(fā)癥包括栓塞10例(8.4%)、出血6例(5.0%),生物瓣置換術(shù)后并發(fā)癥包括栓塞9例(5.0%)、瓣膜結(jié)構(gòu)性毀損4例(2.2%)、瓣膜非結(jié)構(gòu)性功能失常2例(1.1%)、瓣膜血栓5例(2.8%)、出血1例(0.6%)、人工瓣心內(nèi)膜炎2例(1.1%),總體的并發(fā)癥發(fā)生率兩組比較差異無統(tǒng)計(jì)學(xué)意義(P=0.318)。生物瓣組8年內(nèi)再次手術(shù)3例(1.7%),機(jī)械瓣未發(fā)生再次手術(shù),但組間比較差異無統(tǒng)計(jì)學(xué)意義(P=0.305)。結(jié)論 60~70歲年齡段患者行二尖瓣機(jī)械瓣或生物瓣置換術(shù)后6年的瓣膜相關(guān)病死率、并發(fā)癥發(fā)生率及再次手術(shù)率無明顯差異。
[Abstract]:Objective to compare and analyze the difference of mitral valve replacement after mitral valve replacement and biological valve replacement in patients aged 60 ~ 70 years. Methods from January 2006 to December 2014, 119 patients with mechanical mitral valve replacement and 181 patients of the same age who underwent mitral valve replacement in cardiovascular surgery department of PLA General Hospital were retrospectively analyzed. The operative mortality, valvular mortality, complication rate and reoperation rate were compared between the two groups. Results the 6-year survival rate in the mechanical valve group was better than that in the biological valve group, but there was no significant difference in valvular mortality between the two groups. The complications of mechanical valve replacement included embolization in 10 cases, hemorrhage in 6 cases, embolization in 9 cases, structural lesion in 4 cases, nonstructural dysfunction in 2 cases, valvular thrombus in 5 cases and valvular thrombus in 5 cases, the complications of mechanical valve replacement included embolization in 9 cases, valvular structural lesion in 4 cases, valvular nonstructural dysfunction in 2 cases, valve thrombus in 5 cases and valvular thrombus in 5 cases. There was no significant difference in the overall incidence of complications between the two groups. In the biological flap group, there were 3 cases of reoperation within 8 years, but there was no reoperation of the mechanical flap, but there was no significant difference between the two groups (P < 0. 305). Conclusion there is no significant difference in valvular mortality, complication rate and reoperation rate in patients aged 60 to 70 years after mitral valve mechanical valve replacement or biological valve replacement.
【作者單位】： 解放軍總醫(yī)院心血管外科;
【分類號(hào)】：R654.2

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