二尖瓣置换术后中远期发生瓣周漏的非感染危险因素分析  

Analysis of non infectious risk factors of perivalvular leakage in the middle and long term after mitral valve replacement

作　　者：樊宗铭 张建卿[1] 王国锋[1] 姬建民 黄华 FAN Zongming;ZHANG Jianqing;WANG Guofeng;JI Jianmin;HUANG Hua(Department of Cardiac Surgery,The Seventh People's Hospital of Zhengzhou,Zhengzhou 450000,China)

机构地区：[1]郑州市第七人民医院心脏外科,450000

出　　处：《心肺血管病杂志》2022年第3期275-278,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:分析二尖瓣置换术后可能引起中远期发生瓣周漏的高风险因素,为行二尖瓣置换手术围手术期预防该类并发症的发生提供借鉴。方法:收集2014年1月至2020年12月期间郑州市第七人民医院行二尖瓣置换术的患者1706例,术后因各种原因再次住院患者106例。通过拟定纳入排除标准,纳入患者49例,男性20例,女性29例,平均年龄51.8岁,随访时间15~62个月。其中,经超声心动图明确诊断为二尖瓣瓣周漏患者16例(A组),无瓣周漏患者33例(B组)。记录两组患者性别、年龄、有无高血压病史、有无糖尿病病史、有无心功能不全、有无心律失常、BMI、白蛋白、球蛋白等,单因素分析筛选潜在高危险因素后,建立二元Logistic回归模型,分析影响二尖瓣置换术后中远期发生瓣周漏的独立危险因素。结果:两组患者BMI(OR=0.547,P<0.05)和白蛋白(OR=0.800,P<0.05),差异有统计学意义。结论:患者BMI和白蛋白水平是二尖瓣置换术后中远期发生瓣周漏的独立危险因素,所以,需要进行二尖瓣置换术的患者,若积极加强营养,补充足够的蛋白,可能会减低瓣周漏的发病率。Objective:To analyze the high-risk factors that may cause mid-to-long-term paravalvular leakage after mitral valve replacement,and provide a reference for the prevention of such complications during the perioperative period of mitral valve replacement surgery.Methods:From January 2014 to December 2020,1706 patients underwent mitral valve replacement in the Seventh People's Hospital of Zhengzhou City were collected.106 patients were re-hospitalized for various reasons after the operation.Through the development of inclusion and exclusion criteria,49 patients,20 males and 29 females were included,with an average age of 51.8 years and a follow-up period of 15-62 months.Among them,16 patients were diagnosed with mitral valve paravalvular leakage by echocardiography(group A),and 33 patients without paravalvular leakage(group B).Record the two groups of gender,age,history of hypertension,history of diabetes,heart failure,arrhythmia,BMI,albumin,and globulin respectively,after single factor analysis,establish a binary logistic regression model,and analyze the independent risk factors of mid-to-long-term paravalvular leakage after mitral valve replacement.Results:BMI(OR=0.547,P<0.05)and albumin(OR=0.800,P<0.05)of the two groups of patients,the difference was statistically significant.Conclutions:It shows that the patient's BMI and albumin levels are independent risk factors for mid-and long-term paravalvular leakage after mitral valve replacement.Therefore,for patients who need mitral valve replacement,if they actively strengthen their nutrition and supplement enough protein,the incidence of paravalvular leakage may be reduced.

关 键 词：二尖瓣置换术 瓣周漏 多因素分析 并发症 围手术期 

分 类 号：R54[医药卫生—心血管疾病]