中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2008年
1期
11-15
,共5页
甘辉立%张健群%张兆光%罗毅%穆军升%周其文%王胜洵%郑斯宏%朱光发%张向峰%刘双
甘輝立%張健群%張兆光%囉毅%穆軍升%週其文%王勝洵%鄭斯宏%硃光髮%張嚮峰%劉雙
감휘립%장건군%장조광%라의%목군승%주기문%왕성순%정사굉%주광발%장향봉%류쌍
肺栓塞%肺动脉%动脉内膜切除术
肺栓塞%肺動脈%動脈內膜切除術
폐전새%폐동맥%동맥내막절제술
Pulmonaty embolism%Pulmonary Artery%Endarteretomy(PTE)
目的 探讨慢性栓塞性肺动脉高压的临床分型特点,并分析手术治疗与非手术治疗慢性栓塞性肺动脉高压的转归.方法 回顾性分析1995年2月至2007年10月收治的63例慢性栓塞性肺动脉高压的诊治资料,按治疗方法进行分组,其中手术治疗组(A组)45例,非手术治组(B组)18例.分别按圣地亚哥医学中心四分型方法和安贞医院改良二分型方法进行分型,并进行统计学分析.结果 A组围手术期死亡6例,在随访期间死亡4例.B组在住院治疗期间死亡2例,随访期间死亡9例.应用Fisher精确概率法检验表明,圣地亚哥分型Ⅰ型A组总生存率显著高于B组(P=0.009),而Ⅱ、Ⅲ、Ⅳ型慢性栓塞性肺动脉高压A组与B组总生存率差异无统计学意义(P=0.338,0.455,0.800).而按安贞医院改良二分型方法分型,中央型慢性栓塞性肺动脉高压A组总生存率显著高于B组(P:0.009),外周型慢性栓塞性肺动脉高压A组与B组总生存率差异无统计学意义(P=0.125).A组中央型、外周型Kaplan-Meier生存曲线5年生存率分别为(91.7 4-8.0)%、(76±8.5)%(P=0.04),B组中央型、外周型的Kaplan-Meier生存曲线5年生存率分别为(42.9±18.7)%、(56.2±10.8)%(P=0.851).结论 与圣地亚哥医学中心四分型方案比较,安贞医院改良二分法分型方案是一个简便有效、对临床更实用的慢性栓塞性肺动脉高压分型方案,对慢性栓塞性肺动脉高压治疗方案的选择、预后判断有一定指导意义.
目的 探討慢性栓塞性肺動脈高壓的臨床分型特點,併分析手術治療與非手術治療慢性栓塞性肺動脈高壓的轉歸.方法 迴顧性分析1995年2月至2007年10月收治的63例慢性栓塞性肺動脈高壓的診治資料,按治療方法進行分組,其中手術治療組(A組)45例,非手術治組(B組)18例.分彆按聖地亞哥醫學中心四分型方法和安貞醫院改良二分型方法進行分型,併進行統計學分析.結果 A組圍手術期死亡6例,在隨訪期間死亡4例.B組在住院治療期間死亡2例,隨訪期間死亡9例.應用Fisher精確概率法檢驗錶明,聖地亞哥分型Ⅰ型A組總生存率顯著高于B組(P=0.009),而Ⅱ、Ⅲ、Ⅳ型慢性栓塞性肺動脈高壓A組與B組總生存率差異無統計學意義(P=0.338,0.455,0.800).而按安貞醫院改良二分型方法分型,中央型慢性栓塞性肺動脈高壓A組總生存率顯著高于B組(P:0.009),外週型慢性栓塞性肺動脈高壓A組與B組總生存率差異無統計學意義(P=0.125).A組中央型、外週型Kaplan-Meier生存麯線5年生存率分彆為(91.7 4-8.0)%、(76±8.5)%(P=0.04),B組中央型、外週型的Kaplan-Meier生存麯線5年生存率分彆為(42.9±18.7)%、(56.2±10.8)%(P=0.851).結論 與聖地亞哥醫學中心四分型方案比較,安貞醫院改良二分法分型方案是一箇簡便有效、對臨床更實用的慢性栓塞性肺動脈高壓分型方案,對慢性栓塞性肺動脈高壓治療方案的選擇、預後判斷有一定指導意義.
목적 탐토만성전새성폐동맥고압적림상분형특점,병분석수술치료여비수술치료만성전새성폐동맥고압적전귀.방법 회고성분석1995년2월지2007년10월수치적63례만성전새성폐동맥고압적진치자료,안치료방법진행분조,기중수술치료조(A조)45례,비수술치조(B조)18례.분별안골지아가의학중심사분형방법화안정의원개량이분형방법진행분형,병진행통계학분석.결과 A조위수술기사망6례,재수방기간사망4례.B조재주원치료기간사망2례,수방기간사망9례.응용Fisher정학개솔법검험표명,골지아가분형Ⅰ형A조총생존솔현저고우B조(P=0.009),이Ⅱ、Ⅲ、Ⅳ형만성전새성폐동맥고압A조여B조총생존솔차이무통계학의의(P=0.338,0.455,0.800).이안안정의원개량이분형방법분형,중앙형만성전새성폐동맥고압A조총생존솔현저고우B조(P:0.009),외주형만성전새성폐동맥고압A조여B조총생존솔차이무통계학의의(P=0.125).A조중앙형、외주형Kaplan-Meier생존곡선5년생존솔분별위(91.7 4-8.0)%、(76±8.5)%(P=0.04),B조중앙형、외주형적Kaplan-Meier생존곡선5년생존솔분별위(42.9±18.7)%、(56.2±10.8)%(P=0.851).결론 여골지아가의학중심사분형방안비교,안정의원개량이분법분형방안시일개간편유효、대림상경실용적만성전새성폐동맥고압분형방안,대만성전새성폐동맥고압치료방안적선택、예후판단유일정지도의의.
Objective To compare the efficacy of conservative or pulmonary thromboendarterectomy (PTE) therapy for chronic thromboembolic pulmonary hypertension (CTEPH) patients according to a new clinical classification scheme.Methods This retrospective study analyzed 63 cases of CTEPH admitted to our hospital from February 1995 to October 2007 and 45 cases were treated surgically (Group A) and 18 cases received conservative therapy(Group B).Results were analyzed using Fisher exact test and t test according to San Diego medical center quartering classification scheme and Anzhen Hospital modified bifurcate classification scheme.Resuits There were 6 operational deaths in Group A and 2 deaths during hospital stay in Group B.During follow-ups(mean 3.6±2.5 years),there were 4 deaths in Group A and 9 deaths in Group B.the totality survival rate is significantly higher in Group A than that in Group B(P＜O.05).For patients with San Diego Type Ⅰ CTEPH,survival rate was significantly higher in Group A compared with Group B(P=0.009)and was similar for patients with type Ⅱ and Ⅲ and Ⅳ CTEPH between the two groups(P=0.338,0.455,0.800).Survival rate was significantly higher in Group A than that in Group B for patients with Anzhen central type CTEPH(P=0.009),but was similar between the two groups for patients with Anzhen peripheral type CTEPH(P:0.125).The Kaplan-Meier survival curve 5 years survival rate in the Group A was(91.7±8.0)% for Anzhen central type and (76.0±8.5)% for Anzhen peripheral type(P=0.04),and the 5 years Kaplan-Meier survival rate in the Group B was(42.9±18.7)% for Anzhen cetntral type and (56.2±10.8)% for Anzhen peripheral type (P-0.851).Conclusion Anzhen Hospital modiried bifurcate classfication scheme is a simple and effctive classification to predict the prosnosis and choose treatment method of CTEPH.
