瓣膜置换术治疗重症风湿性心脏瓣膜疾病的临床疗效研究  

Clinical Efficacy of Valve Replacement in the Treatment of Severe Rheumatic Heart Valve Disease

作　　者：赵阳[1] 殷传军[1] 冯立锋 冯喆[1] 高继东[1] 郑明非[1] ZHAO Yang;YIN Chuanjun;FENG Lifeng;FENG Zhe;GAO Jidong;ZHENG Mingfei(Beijing Sixth Hospital,Department of Thoracic and Cardiovascular Surgery,Beijing,100007 China)

机构地区：[1]北京市第六医院胸心血管外科,北京100007

出　　处：《世界复合医学》2021年第10期39-42,共4页World Journal of Complex Medicine

摘　　要：目的分析重症风湿性心脏瓣膜疾病患者接受瓣膜置换术治疗对其临床疗效产生的影响。方法选择2016年9月—2021年2月该院接受诊治的40例重症风湿性心脏瓣膜疾病患者为研究对象,按照随机抽签的原则将患者平均分为两组(即参考组、分析组),各20例,分别应用二尖瓣分离术治疗、瓣膜置换术治疗,针对两组患者临床诊治效果展开分析研究。结果分析组体外循环时间(98.89±19.21)min及主动脉阻断时间(85.02±21.15)min均显著低于参考组(128.71±21.54)min、(108.98±30.28)min,差异有统计学意义(t=4.620、2.901,P<0.05);同时其手术后每分钟心输出量(5.91±0.18)L/min、心脏指数(3.55±0.27)min·m^(2)、左心室射血分数(0.62±0.18)%均高于参考组(4.11±0.12)L/min、(2.99±0.63)min·m^(2)、(0.49±0.12)%,差异有统计学意义(t=37.210、3.653、2.687,P<0.05);临床总疗效95.00%高于参比组60.00%,差异有统计学意义(χ^(2)=5.161,P<0.05)。结论通过采用瓣膜置换术对重症风湿性心脏瓣膜疾病实施临床诊治,可以产生较为理想的诊疗效果,并缩短体外循环时间以及主动脉阻断时间,使患者心功能指标得到有效提升,因此适合推广普及。Objective To analyze the effect of valve replacement on the clinical efficacy of patients with severe rheumatic heart valve disease.Methods 40 patients with severe rheumatic heart valve disease who came to the hospital for diagnosis and treatment from September 2016 to February 2021 were selected as the research objects,and the patients were divided into two groups(reference group and analysis group)according to the principle of random drawing,20 cases in each groups,and they were treated with mitral valve separation and valve replacement respectively.The clinical diagnosis and treatment effects of the two groups were analyzed and researched.Results The cardiopulmonary bypass time(98.89±19.21)min and the aortic block time(85.02±21.15)min in the analysis group were significantly lower than the reference group(128.71±21.54)min and(108.98±30.28)min,the difference was statistically significant(t=4.620,2.901,P<0.05);meanwhile,its cardiac output per minute after surgery(5.91±0.18)L/min,cardiac index(3.55±0.27)min·m^(2),left ventricular ejection fraction(0.62±0.18)%,which were higher than the reference group(4.11±0.12)L/min,(2.99±0.63)min·m^(2),(0.49±0.12)%,the difference was statistically significant(t=37.210,3.653,2.687,P<0.05);clinical The total curative effect was 95.00%higher than the reference group 60.00%,and the difference was statistically significant(χ^(2)=5.161,P<0.05).Conclusion The clinical diagnosis and treatment of severe rheumatic heart valvular disease by valve replacement surgery can produce a more ideal diagnosis and treatment effect,shorten the time of extracorporeal circulation and aortic block time,and effectively improve the patient's heart function index,so it is suitable for popularization.

关 键 词：瓣膜置换术 重症风湿性心脏瓣膜疾病 治疗效果 二尖瓣分离术 

分 类 号：R654[医药卫生—外科学]