心脏瓣膜手术同期行冠状动脉旁路术治疗冠心病合并心脏瓣膜病疗效观察  

Effects of cardiac valvular surgery combined with coronary artery bypass surgery in treatment of coronary heart disease and heart valvular disease

作　　者：赵博 梁飞 王燕 崔挪 ZHAO Bo;LIANG Fei;WANG Yan(Department of Cardiac Surgery,The Second People＇s Hospital of Nanyang City,Henan 473000,China)

机构地区：[1]河南省南阳市第二人民医院心外科,473000

出　　处：《淮海医药》2018年第5期517-519,522,共4页Journal of Huaihai Medicine

摘　　要：目的:探讨心脏瓣膜手术联合冠状动脉旁路手术治疗冠心病合并心脏瓣膜病的临床效果。方法:选择某院治疗的96例冠心病合并心脏瓣膜病患者,采用随机数表法分为2组,每组各48例。观察组接受冠状动脉旁路手术同期实施心脏瓣膜手术治疗,对照组行冠状动脉旁路手术非同期行心脏瓣膜手术。观察2组患者ICU监护时间、呼吸机应用时间、住院时间及手术前、后心功能变化情况等。结果:2组患者ICU监护时间、呼吸机应用时间、住院时间比较,观察组少于对照组,差异有统计学意义(P<0.05);术前2组患者心功能分级比较,差异无统计学意义(P>0.05),术后观察组心功能分级低于对照组,差异有统计学意义(P<0.05);术前2组患者左室射血分数、左心室舒张内径、左心室舒张末容积比较,差异无统计学意义(P>0.05),术后观察组左室射血分数高于对照组,左心室舒张内径、左心室舒张末容积小于对照组,差异有统计学意义(P<0.05)。结论:冠心病合并心脏瓣膜病患者应用冠状动脉旁路手术同期实施心脏瓣膜手术治疗效果良好,利于提升患者心功能,缩短患者住院时间,加快患者机体康复。Objective：To observe the effect of cardiac valvular surgery combined with coronary ariery bypass surgery in treatment of coronary heart disease （CHD） and heart valvular disease. Methods ：96 patients with CHD and heart valvular disease in a hospital were selected and randomly divided into two groups, with 48 cases in each group. The control group was given coronary artery bypass surgery with simultaneous cardiac valvular surgery, while the control group was treated with coronary artery bypass surgery only. The intensive care unit （ICU） monitoring time, ventilator application time, hospital stays, changes of cardiac function in the two groups were ob- served. Results：The ICU monitoring time, ventilator application time, hospital stays in the observation group were less than those in the control group （ P 〈 0.05 ）. Before the surgery, there was no statistical difference in the cardiac functional grading between the two groups （ P 〉 0.05 ）, but after the surgery, the grading of the observation group was lower than that of the control group （ P 〈 0.05 ）. There was no statistical difference before the surgery in terms of the left ventricular ejection fraction, left ventricular diastolic dimen- sion, and left ventricular end-diastolic volume between the two groups （ P 〉 0.05 ）. After the treatment, however, the left ventricular e- jection fraction of the observation group was higher than that of the control group, and the left ventricular diastolic dimension and left ventricular end-diastolic volume were smaller than those of the control group （ P 〈 0.05 ）. Conclusion ： Cardiac valvular surgelry com- bined with simultaneous coronary artery bypass surgery in treatment of CHD and heart valvular disease is effective. It can improve car- diac function, shorten hospital stays and accelerate patients＇ recovery.

关 键 词：冠心病 心脏瓣膜疾病 心脏瓣膜手术 冠状动脉旁路术 

分 类 号：R541.4[医药卫生—心血管疾病] R542.5[医药卫生—内科学]