国产GK-2型人工心脏瓣膜的临床应用20年报告  

GK-2 prosthetic heart valve: twenty-year experience

作　　者：仲京[1] 万士杰[1] 张红超[1] 于鲁峰[1] 陈元恒[1] 徐金星[1] 

机构地区：[1]空军总医院心血管外科,北京100036

出　　处：《空军总医院学报》2005年第1期31-34,共4页Journal of General Hospital of Air Force,PLA

摘　　要：目的报告近20年间共应用402枚GK-2型侧倾式碟瓣行瓣膜替换术301例患者的效果。方法男性113例,女性188例。年龄1.6～68(37.59±10.23)岁。心功能Ⅱ级21例,Ⅲ级193例,Ⅳ87例。术式为二尖瓣置换(MVR)183例(60.80%),二尖瓣及主动脉瓣置换(DVR)92例(30.56%),主动脉瓣置换(AVR)21例(6.98%),三尖瓣置换(TVR)5例(1.66%)。术后48h胸腔引流管拔出后给予口服华法令或新抗凝片,凝血酶元时间维持在正常的1.5～2倍(PTR)。本组共使用GK-2型二尖瓣290枚,主动脉瓣112枚(其中自行设计的波浪缝合缘主动脉瓣51枚)。结果早期死亡10例,死亡率为3.32%(10/301)。术后早期无瓣周漏、机械瓣故障等瓣膜相关死亡。对生存的291例随访31d至20年,平均随访10.48±4.35年。所有受访者死亡17例。术后心功能均有不同程度的改善,多数心功能恢复至Ⅰ、Ⅱ级。结论经20年的临床应用和术后随访观察,该型瓣膜具有多项优点,临床应用可靠,促进了国产瓣膜在治疗瓣膜病中的作用,大大降低了医疗成本。Objective The GK-2 mechanical heart valve was introduced in 1985. We first impanted it in 1986. The purpose of this study was to analyze our 20-year clinical experience. Methods Between march 1985 and june 2004, 402 valves were implanted in 301 patients, 113 men and 188 women with a mean age of 37. 59±10. 23 years. Ninety-one percents had NYHA class Ⅲ or Ⅳ heart function. The single valve replacement was performed in 92 patients. Follow-up is 89% and extended 1 to 20 years with cumulative 2252. 3 patient-years. Results The early mortality was 3. 32% (10/30). The main causes of death included low cardiac output sydroml (LCOS) in 5 patients, operated valvular endocarditis, bleeding and arrhythmia. There were 17 late deaths (1. 39% per patient-year). The congestive heart failure, arrhythmia and bleeding were the major reasons. In 92. 3% of survivors heart functional performance had improved to NYHA class Ⅱ or class Ⅰ. Conclusion Early and long-term results demonstrate that the GK-2 prosthetic heart valve exhibits us excellent hemodynamic properties, mechanical durability and a low incidence of valve-related complications.

关 键 词：心脏瓣膜 人工 心脏瓣膜疾病/外科学 随访研究 

分 类 号：R195.1[医药卫生—卫生统计学] R318.11[医药卫生—卫生事业管理]