两种缝合方法行主动脉瓣机械瓣置换的围手术期对比.docxVIP

两种缝合方法行主动脉瓣机械瓣置换的围手术期对比 连云港市第一人民医院心脏外科江苏省连云港市222000 【摘 要】目的：采用不同缝合方法行主动脉瓣机械瓣置换术围手术期的情况比 较。方法：回顾我院自2011年1月至2012年1月收治的40例主动脉瓣病变患 者，其中第一组(T1) 22例采用了常规雅克线带垫片间断褥式缝合，另外第二 组(T2) 18例采用3-0prolene线分别在每个象限内连续缝合后分别打结。比较 这两种手术方式的体外循环时间，升主动脉阻断时间，术后监护室住院时间，术 后并发症及死亡率发牛概率。结果：传统缝合组休外循环时间、升主动脉阻断时 间明显短于连续缝合组，两组相比存在统计学意义。术后两组监护室时间无差别; 术后瓣周漏发生第一组2例，第二组1例，发牛率相比无意义。术后每组各有2 例发生急性肾损伤，相比无统计学意义。术后第一组有1例发生死亡，第二组2 例发生死亡。两组死亡率相比无统计意义。结论：两种方法各有优缺点，术前、 术中需要根据患者疾病类型，患者的个体差异和术中所遇情况再作决定。 【关键词】主动脉瓣置换；连续缝合；间断褥式缝合 Objective： Comparison the differences in the replacement of aortic valves when taken different methords during perioperative. Methords： A retrospectively research in a total of 40 patients who got aortic valve diseases from January2011 to January 2012 in our hospital, divided into 2 groups . Group 1 in eluded 22 patie nts, Group 2 in eluded 18 patie nts.Group 1 carried the operation with traditional methord一 mattress sutured with gaskets discontinuously .Group 2 used a prolenen sutured the mechanical valves continu ously in each quadra nt. Compared the cardiopulm on ary bypass time Aortic cross-clamping time ICU reside nee time and the complicati ons, mortalities in two groups . Results： The cardiopulm on ary bypass time and the aortic cross-clamping time was Ion ger in group 2 tha n in group 1, it was marked differe nces」CU reside nee time had no statistically differe nces, Two patie nts got the complication of perivalvular leakage after the operation in group one in group 2. The occurrences of perivalvular leakage between two groups got no differenee. AKI happened in two patients after operation in each group .The occurrences had no difference . After operation one patient died in group 1, two in group 2 .The mortality in two groups got no sign讦icant differenee . Conclusion： Neither methord was superior than another.so when carried the operation we should according to different situation ? KEY WORDS： Replacement Of Aortic Valves Continuous Suture Discontinuous Mattress Suture 主动脉瓣疾病在心脏外科是一类