摘要
目的研究老年患者行心脏瓣膜置换术的治疗效果，总结手术治疗经验。方法回顾性分析2008年1月至2011年12月在我院行心脏瓣膜置换术的76例老年患者的临床资料及随访情况，分析手术方式的选择、一般效果、术后死亡和并发症情况、随访中患者生存率和生活质量。结果无术中死亡，术后早期病死4例，早期病死率为5．3％。术后31例出现并发症，发生率为40．8％，包括呼吸功能不全、肺部感染、心律失常、切口感染、胸腔积液、低心排血量综合征、肾功能不全等。随访时间为18个月至52个月，平均（24．7士3．6）个月。失访5例，随访率为93．4％。手术1个月后死亡6例，病死率7．9％。生存患者心功能得到不同程度的改善，最后1次随访结果心功能Ⅰ～Ⅱ级47例，Ⅲ级13例，Ⅳ级6例。结论正确判断手术适应证、充分做好术前准备、术中严谨操作并做好心肌保护、术后加强监护，有助于降低老年心脏瓣膜置换术患者的病死率，减少并发症。
Objective To investigate the efficacy of heart value replacement on elderly patients and summarize the experience of surgical treatment. Methods The clinical data and follow-up status of 76 elderly patients were analyzed retrospectively in our hospital from January 2008 to December 2011. The operative method, general effect, postoperative death, postoperative complications, survival rate and life quality followed-up were analyzed. Results No intraoperative death appeared and there were 4 early operative deaths with a mortality rate of 5.3% .There were 31 cases occurred postoperative complication with a complication rate of 40.8% which including respiratory insufficiency, lung infection, arrhythmia, incision infection, pleural effusion, low cardiac output syndrome and renal insufficiency. The follow-up time was 18-52 months and the mean follow-up time was （24.7±3.6）months. There were 5 cases lost of follow up and the follow-up rate was 93.4%. There were 6 patients died after a month postoperative with a mortality rate of 7.9%. The heart function of the survivors achieved differed degree improvements and the result at the end of follow-up were grade Ⅰ-Ⅱ 47 cases, grade Ⅲ 13 cases and grade Ⅳ 6 cases. Conclusions To correctly determine the surgery indications, do all the preoperative preparation,intraoperative rigorous operating with a good myocardial protection and to strengthen the postoperative care will be help to reduce the mortality and complications of the elderly patients with heart value replacement.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2013年第1期22-24,共3页
Chinese Journal of Geriatrics
关键词
心脏瓣膜病
心脏瓣膜假体植入
Heart value diseases
Heart value prosthesis implantation
