心脏瓣膜置换术后围术期并发症的多因素分析  

The Multivariate Analysis of the Perioperative Complications about the Patients with Heart Valve Replacement

作　　者：吴小永[1] 李全民[1] 张满堂[1] 

机构地区：[1]河南省焦作市人民医院心胸外科,河南焦作454002

出　　处：《中国医药指南》2013年第6期10-12,共3页Guide of China Medicine

摘　　要：目的探讨手术前情况、手术方式及围手术期处理等对心脏瓣膜置换手术后围术期并发症的影响。方法收集216例行心脏瓣膜置换术患者的病历资料,详细统计围术期发生的并发症,对术前及围术期可能与并发症有关的相关因素进行统计学分析。结果①216例瓣膜置换手术中,二尖瓣和主动脉瓣双瓣置换术围术期并发症发生率明显高于二尖瓣置换组和主动脉瓣置换组。②Logistic回归分析结果显示:二尖瓣与主动脉瓣联合置换,术前心功能Ⅳ级,术中心脏阻断时间≥110min,体外循环时间≥150min,术后呼吸机支持时间过长≥24h等是影响心脏瓣膜置换术患者围手术期并发症的危险因素。结论双瓣膜置换术,术前心功能差,术中阻断主动脉时间过长,体外循环时间过长,术后呼吸机支持时间过长等是影响心脏瓣膜置换术后围术期并发症的危险因素。Objective To study the effects of preoperative condition,operative methods and perioperative management on the complications of the patients with heart valve replacement in perioperative period.Methods To collect the 216 cases data of the patient with heart valve replacement,To statistic the perioperative complications and analyse the possible factors about the perioperative complications of preoperation and perioperation.Results ①Aortic and mitral valve replacement group caused complication incidence relatively higher than those with mitral valve replacement group and aortic valve replacement group.②Logistic regression analysis suggest that preoperative definite diagnosis of both aortic and mitral valve lesion,preoperative left ventricular dysfunction IV,intraoperative aortic clamping time≥110min,cardiopulmonary bypass（CPB） time ≥150min,postoperative respirator support time ≥24h are risky factors of perioperative complication incidence rate after heart valve replacement.Conclusions Aortic and mitral valve replacement,preoperative left ventricular dysfunction,prolonged aortic clamping and CPB and postoperative respirator support time are the risky factors of perioperative complications incidence rate after heart valve replacement.

关 键 词：心脏瓣膜置换 围术期并发症 多因素分析 

分 类 号：R542.5[医药卫生—心血管疾病]