心脏瓣膜替换术围术期死亡及并发症相关因素的临床分析  

Clinical Analyses of Determinants of Perioperative Mortality and Complications After Cardiac Valve Replacement

作　　者：罗军 朱晓东[1,2] 萧明第[1,2] 刘迎龙[1,2] 吴清玉[1,2] 孙立忠[1,2] 吴信[1,2] 

机构地区：[1]中国医学科学院中国协和医科大学心血管病研究所,北京市邮政编码100037 [2]中国医学科学院中国协和医科大学阜外心血管病医院,北京市邮政编码100037

出　　处：《中国循环杂志》1996年第3期159-163,共5页Chinese Circulation Journal

摘　　要：目的:通过临床分析,提出影响或导致心脏瓣膜替换术围术期死亡及主要并发症的相关因素,以期降低围术期死亡率及并发症发生率。方法:收集整理病历资料(2218例),输入计算机,进行单因素及多元回归分析。结果:围术期死亡及某些主要并发症与术前、术中及术后某些因素显著相关,如术前心功能Ⅲ、Ⅳ级。心胸比率≥0.70,左心室舒张末期内径≥70 mm,心脏阻断时间及体外循环时间较长及术中心肌保护不满意等。结论:心脏瓣膜替换术围术期死亡及并发症与术前、术中及术后某些因素显著相关。在今后的临床工作中,避免这些相关因素的存在或发生,或有某些相关因素存在时,警惕其相应并发症发生,这样可望降低围术期死亡率及并发症发生率。Objective:To define the independent predictors of perioperative death and complications after cardiac valve replacement by clinical analyses so as to decrease perioperative mortality and morbidity. Methods: Preoperative,intraoperative and postoperative variables of 2218 cases were collected and tested retrospectively for correlation with the perioperative mortality and morbidity using univariate test and multivariate logistic regression analysis. Results: Perioperative mortality and morbidity correlated significantly with some of the perioperative variables, such as higher NYHA functional class (Ⅳ or Ⅳ),large left ventricular end-diastolic diameter (≥70 mm), prolonged aortic cross-clamping time and cardiopulmonary bypass time,unsatisfactory myocardial protection, etc. Conclusion:Independent predictors of perioperative mortality and morbidity for cardiac valve replacement were identified in this retrospective study. Measures to avoid the occurrence of these independent predictors or to correct them timely might effectively decrease the perioperative mortality and morbidity.

关 键 词：相关因素 围术期 死亡率 并发症率 

分 类 号：R654.2[医药卫生—外科学]