大心脏瓣膜置换术治疗大左心室心脏瓣膜病临床效果.docVIP

大心脏瓣膜置换术治疗大左心室心脏瓣膜病临床效果 　　[摘要] 目的 探?大左心室心脏瓣膜病应用心脏瓣膜置换术治疗的临床效果及其影响因素。 方法 采用随机抽选法从本院2010年1月～2016年1月期间收治的大左心室心脏瓣膜病患者中抽取60例作为本次研究对象，观察心脏瓣膜置换术后的临床效果及并发症发生情况，并采用Logistic回归分析影响并发症发生的因素。 结果 60例患者术后死亡2例（3.33%），出现并发症情况42例（70.00%），其中23例（38.33%）是室性心律失常，通过术后15 d的观察，患者心脏形态及功能指标明显降低。通过Logistic单因素回归分析显示，LVEDD80 mm、LVEF60 mm、年龄50岁、体外循环时间108 min、风湿性心脏瓣膜病、术前非窦性心律、NYHA Ⅲ 级或 Ⅳ 级与术后室性心律失常相关，是引起术后室性心律失常的重要危险因素。通过Logistic多因素回归分析显示，术前非窦性心律、NYHA Ⅲ 级或 Ⅳ 级是引发术后室性心律失常的主要危险因素。 结论 临床治疗大左心室心脏瓣膜病应用心脏瓣膜置换术治疗能明显改善患者心脏形态及心功能，术后早期死亡率较低，提高了患者远期的生存率。术前非窦性心律、NYHA Ⅲ 级或 Ⅳ 级是引发术后室性心律失常的主要危险因素，可能会增加患者远期死亡率 [关键词] 大左心室心脏瓣膜病；心脏瓣膜置换术；影响因素；回归分析 [中图分类号] R542.5；R654.2 [文献标识码] B [文章编号] 1673-9701（2017）11-0068-03 Clinical effect of large heart valve replacement in the treatment of large left ventricular valvular heart disease WANG Zhisheng ZHANG Huawei CHEN Fu’nan WU Jian Department of Cardiothoracic Surgery，Longyan First Hospital Affiliated to Fujian Medical University，Longyan 364000，China [Abstract] Objective To explore the clinical effect and influencing factors of heart valve replacement in patients with large left ventricular valvular heart disease. Methods 60 patients with large left ventricular valvular heart disease admitted in our hospital from January 2010 to January 2016 were randomly selected. The clinical effect of heart valve replacement and the incidence of complications were observed，and the factors that affect the occurrence of complications were analyzed by Logistic regression. Results Of the 60 cases，2 cases were died（3.33%）. 42 cases had complications（70.00%）， and 23 cases were ventricular arrhythmia（38.33%）. After the observation of postoperative 15 days， the patient’s heart morphological and functional indicators were significantly decreased. Logistic univariate regression analysis showed that LVEDD80 mm， LVEF60 mm， age50 years， cardiopulmonary by pass time108 min， rheumatic valvular heart disease， preoperative non-sinus rhythm， NYHA class Ⅲ or grade Ⅳ were related with postoperat