52例人工生物瓣膜临床应用分析  

Retrospective study on clinical application of biovalves in 52 cases

作　　者：李峰[1] 胡建国[1] 尹邦良[1] 杨进福[1] 唐滔[1] 高华[1] 

机构地区：[1]中南大学湘雅二医院胸心外科

出　　处：《中南大学学报（医学版）》2008年第3期257-261,共5页Journal of Central South University ：Medical Science

基　　金：卫生部临床学科重点项目(2001-321)~~

摘　　要：目的：总结分析异种心脏生物瓣膜置换的临床应用结果，评价生物瓣膜在瓣膜外科中的应用效果及趋势。方法：回顾性分析2002年6月～2006年6月，在我科接受异种生物瓣膜置换术的患者52例，年龄13～73（52．4±14．0）岁，手术置入生物瓣膜53枚，合用机械瓣膜8枚；同期行双向Glenn分流术1例，B型预激旁路切除术1例，冠脉搭桥术5例；房／室间隔缺损修补4例。结果：术后早期（30d内）死于多器官功能衰竭1例。平均随访25个月，随访率96％。随访病例生存良好，心功能I级41例、Ⅱ级9例、Ⅲ级1例。心脏彩超示瓣膜功能良好，无明显衰败迹象。结论：人工生物瓣膜置换疗效确切，并发症少，在保证手术技术的情况下，近期效果较好。Objective To summarize the clinical application of bioprothetic valve replacement. Methods Fifty two patients, aged 13-73 （ 52.4 ＋ 14.0 ） years, underwent cardiac valve replacement with biovalves from June 2002 to June 2006 in our hospital. Fifty three tissue valve replacements combined with 8 mechanical valve replacements were performed. Other procedures were also carried out if appropriate, including bidirectional Glenn shunt in 1 patient with double outlet of right ventricle and pulmonary artery stenosis ; interruption of accessory pathway in 1 patient with Wolff-Parkinson-White syndrome; coronary artery bypass graft in 5 with severe coronary artery disease; and atrial or ventricular repair in 4 with congenital septum defects. Results One patient died in hospital due to multiple organ failure. The hospital mortality rate was 1.9 % . The mean fol-low-up was 25 months. Two patients lost follow-up and the follow-up rate was 96%. Forty one patients returned to NYHA class I , 9 to class II, and 1 to class III. Echocardiography showed the implanted bioprosthesis functioned well without stenosis or regurgitation. There was no structural deterioration with freedom from thromboembolism and anticoagulant hemorrhage in all patients. Conclusion The efficacy of biovalves in heart valve replacement is satisfactory.

关 键 词：瓣膜置换术 生物瓣膜 临床应用 

分 类 号：R654.2[医药卫生—外科学]