【摘要】：目的:回顧性分析心臟術后三尖瓣關閉不全行三尖瓣置換術死亡危險因素,評價New EuroSCOREⅡ?qū)θ獍曛脫Q術后風險的預測作用。方法:回顧性分析77例心臟術后再次行三尖瓣置換術病例的臨床資料,將臨床資料分為死亡組與存活組,對入選者的臨床資料進行單因素統(tǒng)計分析,變量資料計算各組平均數(shù)±標準差,并對分組資料行t檢驗,計算P值,變數(shù)資料計算各組頻數(shù)及構成比,并對分組資料行卡方檢驗,計算P值。將單因素統(tǒng)計分析結果有統(tǒng)計學意義(P0.05)的因素帶入Logistic回歸模型,分析術前及術中多種因素對心臟術后行三尖瓣置換術后死亡的影響。分別計算死亡組與非死亡組New Euro SCOREⅡ評分的平均數(shù)±標準差,對兩組資料行t檢驗,并計算P值。結果:77例患者中術后早期在院死亡8例,死亡率10.4%。單因素分析顯示術前NYHAⅣ級、右心衰、肺動脈壓力(58mm Hg)、總膽紅素(50umol/L)、肌酐(90 umol/L)、尿素(12mmol/L)、尿酸(560 umol/L)、無心房顫動與術后早期死亡有顯著性意義(P0.05),術中體外循環(huán)時間(200min)、心肌保護液(2500m L)、升主動脈阻斷時間(80min)及置換瓣膜過小與術后早期死亡有統(tǒng)計學意義(P0.05)。多因素Logistic回歸模型分析表明術前肌酐(90 umol/L)、無心房顫動是心臟術后再次行三尖瓣置換術早期病人死亡的獨立危險因素(P0.05)。統(tǒng)計結果顯示死亡組與非死亡組Euroscore評分的差異有統(tǒng)計學意義。結論:心臟術后遠期因三尖瓣關閉不全行三尖瓣置換有諸多危險因素與術后早期死亡有關,術前要特別注意對腎功能異常和無心房顫動患者的準備工作,New Euro SCOREⅡ可以作為預測此類手術風險的可靠評分系統(tǒng)。
[Abstract]:Objective: to analyze the risk factors of tricuspid valve replacement for tricuspid valve insufficiency after cardiac surgery and to evaluate the predictive effect of New EuroSCORE II on the risk of tricuspid valve replacement. Methods: the clinical data of 77 patients undergoing tricuspid valve replacement after cardiac surgery were analyzed retrospectively. the clinical data were divided into death group and survival group. The mean 鹵standard deviation of each group was calculated by variable data, t test was performed on the grouped data, P value was calculated, the frequency and composition ratio of each group were calculated by variable data, and chi-square test was performed to calculate the P value of the grouped data. The factors with statistical significance (P 0.05) were brought into the Logistic regression model to analyze the effects of various factors on the death after tricuspid valve replacement before and during cardiac surgery. The average 鹵standard deviation of New Euro SCORE 鈪，

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