同期手术治疗老年风湿性心脏瓣膜病合并冠心病疗效及可行性评价  

Evaluation of the Efficacy and Feasibility of Simultaneous Surgery for Elderly Rheumatic Valvular Heart Disease Complicated With Coronary Heart Disease

作　　者：侍巍[1] 缪丙荣[1] 李伟[1] 王蔚[1] 张伟[1] 李建明[1] SHI Wei MIAO Bingrong LI Wei WANG Wei ZHANG Wei LI Jianming(Department of Cardiac Surgery, Xuzhou Central Hospital, Xuzhou Jiangsu 221000, China)

机构地区：[1]徐州市中心医院心脏外科,江苏徐州221000

出　　处：《中国继续医学教育》2017年第17期143-144,共2页China Continuing Medical Education

摘　　要：目的分析同期手术治疗老年风湿性心脏瓣膜病合并冠心病疗效及可行性。方法选取2015年1月—2016年12月在我院接受治疗的老年风湿性心脏瓣膜病合并冠心病患者31例作为研究对象,观察其指标改善情况。结果仅1例术前心功能分级为Ⅳ级,手术后第5天死于低心排,其他患者经有效治疗以及护理后均康复出院。治疗后,康复患者的心功能级数显著降低,6 min步行距离显著延长,且左室舒张末内径以及收缩末期内径显著降低,左室射血分数明显升高,与治疗前相比,差异具有统计学意义(P<0.05)。结论同期手术治疗老年风湿性心脏瓣膜病合并冠心病疗效显著。Objective To analyze the efficacy and feasibility of concurrent surgical treatment of rheumatic heart disease with coronary heart disease. Methods 31 patients with rheumatic heart valve disease complicated with coronary heart disease treated in our hospital from January 2015 to December 2016 were selected as the study subjects, and the improvement of their indexes was observed. Results Only 1 patient had grade IV cardiac function before operation. They died of low cardiac output fifth days after operation. All the patients were discharged after effective treatment and nursing. After treatment, the cardiac function progression of rehabilitation patients decreased significantly, 6 min walking distance was significantly extended, the left ventricular end diastolic diameter and the end systolic diameter decreased significantly, left ventricular ejection fraction was significantly increased, compared with before treatment, the difference was statistically significant （P 〈 0.05）. Conclusion The surgical treatment of rheumatic heart valve disease complicated with coronary heart disease in the same period is effective.

关 键 词：同期手术 老年风湿性心脏瓣膜病 冠心病 

分 类 号：R541[医药卫生—心血管疾病]