心脏瓣膜置换同期左心耳结扎对患者心功能的影响和血浆BNP浓度的意义  

Effect of Left Atrial Appendage Ligation on Cardiac Function and Significance of Plasma BNP Concentration in Patients Undergoing Cardiac Valve Replacement

作　　者：曾新敏[1] 王晖[1] 陈华[1] 胡火利[1] ZENG Xinmin;WANG Hui;CHEN Hua;HU Huoli(First Hospital of Nanchang City,Nanchang 330008,China)

机构地区：[1]南昌市第一医院

出　　处：《现代医院》2019年第12期1849-1851,共3页Modern Hospitals

基　　金：江西省卫生计生委科技计划项目(20187014)

摘　　要：目的探讨心脏瓣膜置换同期左心耳结扎对患者心功能的影响和血浆BNP浓度的意义。方法选取2018年1月—2019年1月收治的心脏瓣膜病患者84例为研究对象,所有患者根据治疗方式的不同分为观察组和对照组各42例,对照组患者均行单纯性瓣膜置换术,观察组患者给予瓣膜置换同期行左心耳闭塞术,比较两组患者心功能、血浆BNP浓度以及术后并发症发生情况。结果术后30 d两组LVEF、LVFS、SV以及CO水平均明显提高,与术前比较差异显著(P<0.05);术后30 d,观察组LVEF、LVFS、SV以及CO水平明显高于对照组,差异显著(P<0.05);术后1 d及术后3 d两组BNP水平较术前均明显升高,差异显著(P<0.05);术后7 d两组BNP水平逐渐下降,其中术后14 d、术后30 d,两组BNP水平较术前比较差异无显著性(P>0.05);观察组术后1 d至术后30 d,BNP水平与对照组比较差异无显著性(P>0.05);观察组术后并发症发生率为7.14%,明显低于对照组的25.57%。经比较差异显著(P<0.05)。结论心脏瓣膜置换手术同期行左心耳结扎术可有效减少心脏瓣膜病患者不良事件的发生,且对患者的心功能影响较小,安全可行,可在临床积极推广应用。Objective To investigate the effect of heart valve replacement on left ventricular atrial ligation on cardiac function and plasma BNP concentration.Methods Eighty-four patients with valvular heart disease admitted to our hospital from January 2018 to January 2019 were enrolled.All patients were divided into observation group and control group according to different treatment methods.The control group was all simple.In the valve replacement group,the patients in the observation group were treated with valve replacement and left atrial appendage occlusion.The cardiac function,plasma BNP concentration and postoperative complications were compared between the two groups.Results The levels of LVEF,LVFS,SV and CO were significantly increased at 30 days after operation,which was significantly different from that before operation(P<0.05).At 30 days after operation,the levels of LVEF,LVFS,SV and CO in the observation group were significantly higher than those in the control group.The difference was significant(P<0.05).The level of BNP in the two groups was significantly higher than that before operation(P<0.05).The level of BNP decreased gradually on the 7th day after surgery.At 30 days after operation,there was no significant difference between the two groups(P>0.05).There was no significant difference between the two groups(P>0.05).The postoperative complication rate was 7.14%,which was significantly lower than the control group’s 25.57%.The difference was significant(P<0.05).Conclusion Cardiac valve replacement surgery with left atrial appendage can effectively reduce the occurrence of adverse events in patients with valvular heart disease,and the patient's heart function is less affected.It is safe and feasible and can be actively applied in clinical practice.

关 键 词：心脏瓣膜置换 左心耳结扎 心功能 血浆BNP 

分 类 号：R654.2[医药卫生—外科学]