中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2011年
13期
33-36
,共4页
宋兵%王邦宁%何金铮%杜荣美
宋兵%王邦寧%何金錚%杜榮美
송병%왕방저%하금쟁%두영미
心脏瓣膜疾病%医院死亡率%心脏瓣膜置换术
心髒瓣膜疾病%醫院死亡率%心髒瓣膜置換術
심장판막질병%의원사망솔%심장판막치환술
Heart valve diseases%Hospital mortality%Cardiac valve replacement
目的 探讨风湿性心脏瓣膜病换瓣手术患者住院病死率及其主要死因.方法 回顾性分析2006年1月至2009年11月明确诊断为风湿性心脏瓣膜病患者130例(所有患者均准备行瓣膜置换术).按其住院是否发生死亡分成死亡组10例和存活组120例.收集其内外科术前临床资料以及合并症和并发症等情况,用Logistic,回归方法分析其住院病死率及其死因.结果 死亡组总胆红素和间接胆红素分别为(30.31±19.10)、(22.38±17.34)μmol/L,均明显高于存活组的(19.47±8.61)、(12.92 ± 7.30)μmol/L,两组比较差异有统计学意义(P＜0.01).死亡组术后并发症、脑梗死病史和心肺合并症发生率明显高于存活组(P＜0.01).多因素Logistic回归分析显示术后并发症为住院死亡的独立危险因素(P=0.002).结论 风湿性心脏瓣膜病换瓣手术患者合并术后并发症是其住院死亡的独立预测因素,加强住院期间治疗及护理尤为重要.
目的 探討風濕性心髒瓣膜病換瓣手術患者住院病死率及其主要死因.方法 迴顧性分析2006年1月至2009年11月明確診斷為風濕性心髒瓣膜病患者130例(所有患者均準備行瓣膜置換術).按其住院是否髮生死亡分成死亡組10例和存活組120例.收集其內外科術前臨床資料以及閤併癥和併髮癥等情況,用Logistic,迴歸方法分析其住院病死率及其死因.結果 死亡組總膽紅素和間接膽紅素分彆為(30.31±19.10)、(22.38±17.34)μmol/L,均明顯高于存活組的(19.47±8.61)、(12.92 ± 7.30)μmol/L,兩組比較差異有統計學意義(P＜0.01).死亡組術後併髮癥、腦梗死病史和心肺閤併癥髮生率明顯高于存活組(P＜0.01).多因素Logistic迴歸分析顯示術後併髮癥為住院死亡的獨立危險因素(P=0.002).結論 風濕性心髒瓣膜病換瓣手術患者閤併術後併髮癥是其住院死亡的獨立預測因素,加彊住院期間治療及護理尤為重要.
목적 탐토풍습성심장판막병환판수술환자주원병사솔급기주요사인.방법 회고성분석2006년1월지2009년11월명학진단위풍습성심장판막병환자130례(소유환자균준비행판막치환술).안기주원시부발생사망분성사망조10례화존활조120례.수집기내외과술전림상자료이급합병증화병발증등정황,용Logistic,회귀방법분석기주원병사솔급기사인.결과 사망조총담홍소화간접담홍소분별위(30.31±19.10)、(22.38±17.34)μmol/L,균명현고우존활조적(19.47±8.61)、(12.92 ± 7.30)μmol/L,량조비교차이유통계학의의(P＜0.01).사망조술후병발증、뇌경사병사화심폐합병증발생솔명현고우존활조(P＜0.01).다인소Logistic회귀분석현시술후병발증위주원사망적독립위험인소(P=0.002).결론 풍습성심장판막병환판수술환자합병술후병발증시기주원사망적독립예측인소,가강주원기간치료급호리우위중요.
Objective To investigate the hospital mortality of rheumatic heart disease (RHD)and major cause of death. Methods One hundred and thirty patients with RHD prepared to take valve replacement from January 2006 to November 2009 were involved in this study. They were divided into two groups according to all clinical data: death group (10 cases ) and survival group (120 cases ). The clinical data and complications were collected, and the hospital mortality and their causes were analyzed with Logistic regression analysis. Results Univariate analysis: total bilirubin and indirect bilirubin levels in death group [(30.31 ± 19.10), (22.38 ± 17.34) μmol/L] were significantly higher than those in survival group [(19.47 ± 8.61),(12.92 ± 7.30) μmol/L] (P ＜ 0.01). The incidence of postoperative complications,history of cerebral infarction and cardiovascular complications in death group were significantly higher than those in survival group (P ＜0.01). The Logistic regression analysis showed that the postoperative complications was an independent risk factor for hospital mortality (P =0.002). Conclusions RHD with postoperative complications is identified as an independent predictor of hospital mortality. It is very important to enhance the treatment and care during hospitalization.
