成人心脏瓣膜置换术后患者康复期不适症状及危险因素分析  

Analysis of Symptoms and Risk Factors of Patients After Cardiac Valve Replacement in Postoperative Rehabilitation

作　　者：陈小康 张远强[1] 童华杰[1] 邓皓文 刘建平[2] 张永恒[2] Chen Xiaokang;Zhang Yuanqiang;Tong Huajie(Department of Cardiothoracic Surgery,Zigong First People's Hospital,Zigong,Sichuan 643000;Department of Cardiovascular Surgery,Suining Central Hospital,Suining,Sichuan 629000,China.)

机构地区：[1]自贡市第一人民医院胸心外科,四川自贡643000 [2]遂宁市中心医院心血管外科,四川遂宁629000

出　　处：《四川医学》2022年第11期1096-1101,共6页Sichuan Medical Journal

摘　　要：目的调查心脏瓣膜置换术后患者康复期不适症状并分析其危险因素。方法选取2019年1月至2020年12月在遂宁市中心医院心血管外科行心脏瓣膜置换手术治疗的360例患者为调查对象,其中男154例、女206例,年龄(59.7±14.3)岁。采用中文版心脏症状调查量表调查患者术后不适症状。结果心脏瓣膜置换术后患者不适症状发生率较高,其中疼痛(53.6%),咳嗽与气短(42.3%),疲劳与困倦(25.6%),心悸(19.7%),睡眠障碍(16.4%)。女性患者更容易发生疼痛(OR=3.681)、心悸(OR=2.053)、睡眠障碍(OR=1.932)、焦虑(OR=3.882)、食欲不佳(OR=3.014)、沮丧(OR=2.505);年龄>60岁的患者更容易发生咳嗽与气短(OR=2.247)、疲劳与困倦(OR=2.195);LVEF<50%的患者更容易发生疲劳与困倦(OR=2.401)、双下肢水肿(OR=3.001)和食欲不佳(OR=0.534);手术时间(OR=2.401)、心房颤动(OR=2.437)、机械瓣膜(OR=5.792)分别是患者术后疼痛、心悸和睡眠障碍的危险因素之一。结论心脏瓣膜置换术后患者康复期存在多种不适症状,不适症状的发生与患者性别、年龄、手术时间、心房颤动、LVEF、瓣膜类型等因素密切相关。Objective To investigate discomfort symptoms in patients after heart valve replacement during rehabilitation period and analyze their risk factors.Methods From January 2019 to December 2020,360 patients with 154 males and 206 females,aged(59.7±14.3)years,who underwent heart valve replacement surgery were selected as investigation subjects.Postoperative discomfort symptoms were investigated by Chinese version of Cardiac Symptom Survey.Results Higher incidence of discomfort symptoms after heart valve replacement were:pain(53.6%),cough and shortness of breath(42.3%),fatigue(25.6%),palpitations(19.7%),and poor sleep(16.4%).Women were more prone to pain or discomfort(OR=3.681),palpitations(OR=2.053),poor sleep(OR=1.932),anxiety or stress(OR=3.882),poor appetite(OR=3.014),depression(OR=2.505).Patients over 60 years were more likely to cough and shortness of breath(OR=2.247),fatigue(OR=2.195).Patients with LVEF<50%were more prone to fatigue(OR=2.401),Swelling legs(OR=3.001)and poor appetite(OR=0.534).Duration of surgery(OR=2.401),atrial fibrillation(OR=2.437)and mechanical valve(OR=5.792)were risk factors for postoperative pain,palpitations and sleep disturbance respectively.Conclusion There would be many uncomfortable symptoms in patients with valvular heart disease after operation,and occurrence of uncomfortable symptoms could be closely related to gender、age、duration of operation、atrial fibrillation、LVEF、valve type and so on.

关 键 词：心脏瓣膜病 术后不适症状 危险因素 

分 类 号：R654.2[医药卫生—外科学]