【摘要】：目的觀察巨大左心室患者行心臟瓣膜置換手術后近中期的手術療效以及探討影響其預后的相關危險因素。方法回顧性分析82例心瓣膜病合并巨大左心室患者行心瓣膜置換術的臨床資料,比較術前術后近中期的心臟大小以及心臟功能的改變,并探討影響其預后的相關危險因素。結果術后近中期左心房內徑、左心室舒張期末內徑、左心室收縮期內徑(LVESD)均較術前減小,差異有統(tǒng)計學意義(P0.05),而術后左心室射血分數(shù)值、左心室縮短率值與術前比較差異無統(tǒng)計學意義,術后心功能分級(NYHA)與術前比較差異有統(tǒng)計學意義(P0.05);影響患者預后的相關危險因素有術前LVESD值≥6.0 cm、心功能NYHA分級在Ⅳ級、術后未使用血管緊張素轉化酶抑制劑(ACEI)類藥物或者β-受體阻滯劑(P0.05)。結論心瓣膜病合并巨大左心室患者行心瓣膜置換術后圍手術期死亡率低,且術后近中期心臟的形態(tài)大小發(fā)生了明顯的逆重構過程,心功能同樣明顯改善,手術療效滿意。心功能Ⅳ級、LVESD≥6.0 cm、術后未使用小劑量的ACEI類藥物或β-受體阻滯劑是影響預后的主要危險因素。
[Abstract]:Objective to observe the curative effect of cardiac valve replacement in patients with giant left ventricle and explore the risk factors affecting its prognosis. Methods the clinical data of 82 patients with valvular heart disease complicated with giant left ventricle were retrospectively analyzed. The changes of heart size and cardiac function were compared before and after operation, and the risk factors affecting the prognosis were also discussed. Results the left atrium diameter, left ventricular end diastolic diameter and left ventricular systolic diameter (LVESD) decreased significantly (P0.05), but left ventricular ejection fraction (LVEF) after operation was significantly lower than that before operation (P0.05), but left ventricular ejection fraction (LVEF) after operation was significantly lower than that before operation (P0.05). There was no significant difference in left ventricular shortening rate between pre-operation and left ventricular shortening rate, but there was significant difference between postoperative cardiac function grading (NYHA) and pre-operation (P0.05). The risk factors influencing the prognosis of the patients were pre-operation LVESD 鈮，

本文編號：2436143