【摘要】：目的觀察巨大左心室患者行心臟瓣膜置換手術(shù)后近中期的手術(shù)療效以及探討影響其預(yù)后的相關(guān)危險因素。方法回顧性分析82例心瓣膜病合并巨大左心室患者行心瓣膜置換術(shù)的臨床資料,比較術(shù)前術(shù)后近中期的心臟大小以及心臟功能的改變,并探討影響其預(yù)后的相關(guān)危險因素。結(jié)果術(shù)后近中期左心房內(nèi)徑、左心室舒張期末內(nèi)徑、左心室收縮期內(nèi)徑(LVESD)均較術(shù)前減小,差異有統(tǒng)計學(xué)意義(P0.05),而術(shù)后左心室射血分數(shù)值、左心室縮短率值與術(shù)前比較差異無統(tǒng)計學(xué)意義,術(shù)后心功能分級(NYHA)與術(shù)前比較差異有統(tǒng)計學(xué)意義(P0.05);影響患者預(yù)后的相關(guān)危險因素有術(shù)前LVESD值≥6.0 cm、心功能NYHA分級在Ⅳ級、術(shù)后未使用血管緊張素轉(zhuǎn)化酶抑制劑(ACEI)類藥物或者β-受體阻滯劑(P0.05)。結(jié)論心瓣膜病合并巨大左心室患者行心瓣膜置換術(shù)后圍手術(shù)期死亡率低,且術(shù)后近中期心臟的形態(tài)大小發(fā)生了明顯的逆重構(gòu)過程,心功能同樣明顯改善,手術(shù)療效滿意。心功能Ⅳ級、LVESD≥6.0 cm、術(shù)后未使用小劑量的ACEI類藥物或β-受體阻滯劑是影響預(yù)后的主要危險因素。
[Abstract]:Objective to observe the curative effect of cardiac valve replacement in patients with giant left ventricle and explore the risk factors affecting its prognosis. Methods the clinical data of 82 patients with valvular heart disease complicated with giant left ventricle were retrospectively analyzed. The changes of heart size and cardiac function were compared before and after operation, and the risk factors affecting the prognosis were also discussed. Results the left atrium diameter, left ventricular end diastolic diameter and left ventricular systolic diameter (LVESD) decreased significantly (P0.05), but left ventricular ejection fraction (LVEF) after operation was significantly lower than that before operation (P0.05), but left ventricular ejection fraction (LVEF) after operation was significantly lower than that before operation (P0.05). There was no significant difference in left ventricular shortening rate between pre-operation and left ventricular shortening rate, but there was significant difference between postoperative cardiac function grading (NYHA) and pre-operation (P0.05). The risk factors influencing the prognosis of the patients were pre-operation LVESD 鈮，

本文編號：2436143