中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2014年
12期
1434-1436
,共3页
心脏瓣膜假体植入%心脏瓣膜疾病%社区卫生服务%康复
心髒瓣膜假體植入%心髒瓣膜疾病%社區衛生服務%康複
심장판막가체식입%심장판막질병%사구위생복무%강복
Heart valve prosthesis implantation%Heart valve diseases%Community health services%Rehabilitation
目的：探讨社区康复管理在防治人工机械瓣膜置换术后患者远期并发症中的意义。方法2001年2月—2012年7月，共计83例金属瓣膜置换患者在杨柳湾镇中心卫生院建立健康档案，接受系统的健康宣教、定期体检、并发症判断和处理。结果随访至2013-05-01，本组患者死亡3例（3,6%），死亡原因为肺癌、创伤、胃癌各1例，无一例因心脏瓣膜病或相关并发症死亡；总抗凝达标人数79例（95,2%）；出血倾向8例（9,6%），经颅脑磁共振成像（MRI）诊断脑出血1例（1,2%）；出现心功能Ⅱ级3例（3,6%）（肺部感染诱发1例，贫血诱发1例，过度劳动诱发1例），均在心功能恶化至Ⅲ级之前发现并就医，无心源性休克发生；新发心房纤颤3例（3,6%），原心房纤颤加重明显影响血流动力学2例（2,4%）；原心房纤颤患者出现室性心律失常1例（1,2%），为感染性心内膜炎患者。结论社区康复管理在防治人工机械瓣膜置换术后患者远期并发症中有重要意义。
目的：探討社區康複管理在防治人工機械瓣膜置換術後患者遠期併髮癥中的意義。方法2001年2月—2012年7月，共計83例金屬瓣膜置換患者在楊柳灣鎮中心衛生院建立健康檔案，接受繫統的健康宣教、定期體檢、併髮癥判斷和處理。結果隨訪至2013-05-01，本組患者死亡3例（3,6%），死亡原因為肺癌、創傷、胃癌各1例，無一例因心髒瓣膜病或相關併髮癥死亡；總抗凝達標人數79例（95,2%）；齣血傾嚮8例（9,6%），經顱腦磁共振成像（MRI）診斷腦齣血1例（1,2%）；齣現心功能Ⅱ級3例（3,6%）（肺部感染誘髮1例，貧血誘髮1例，過度勞動誘髮1例），均在心功能噁化至Ⅲ級之前髮現併就醫，無心源性休剋髮生；新髮心房纖顫3例（3,6%），原心房纖顫加重明顯影響血流動力學2例（2,4%）；原心房纖顫患者齣現室性心律失常1例（1,2%），為感染性心內膜炎患者。結論社區康複管理在防治人工機械瓣膜置換術後患者遠期併髮癥中有重要意義。
목적：탐토사구강복관리재방치인공궤계판막치환술후환자원기병발증중적의의。방법2001년2월—2012년7월，공계83례금속판막치환환자재양류만진중심위생원건립건강당안，접수계통적건강선교、정기체검、병발증판단화처리。결과수방지2013-05-01，본조환자사망3례（3,6%），사망원인위폐암、창상、위암각1례，무일례인심장판막병혹상관병발증사망；총항응체표인수79례（95,2%）；출혈경향8례（9,6%），경로뇌자공진성상（MRI）진단뇌출혈1례（1,2%）；출현심공능Ⅱ급3례（3,6%）（폐부감염유발1례，빈혈유발1례，과도노동유발1례），균재심공능악화지Ⅲ급지전발현병취의，무심원성휴극발생；신발심방섬전3례（3,6%），원심방섬전가중명현영향혈류동역학2례（2,4%）；원심방섬전환자출현실성심률실상1례（1,2%），위감염성심내막염환자。결론사구강복관리재방치인공궤계판막치환술후환자원기병발증중유중요의의。
Objective To explore the significance of community - based rehabilitation and health management in pre-venting and treating long - term complications after mechanical heart valve replacement, Methods During February 2001 to July 2012,83 prosthetic valve implanted patients were included and their health archives were established, All the patients included were given health education,periodic physical examination and complication diagnosis and treatment, Results Follow - up to May 1st,2013,of the 83 patients,no one died of valve disease or complications but three patients(3, 6% )died of lung canc-er,trauma and gastric cancer respectively;79 patients(95, 2% )reached the presupposed anticoagulation standard;8 patients (9, 6% )experienced hemorrhagic tendency and one patient were diagnosed as encephalorrhagia by using MRI;3 patients (3, 6% )were diagnosed as cardiac function NAHY grade Ⅱ and their heart failure was induced by pneumonia,anemia and over-work respectively,but no cardiac shock occurred;3 patients(3, 6% )were diagnosed as atrial fibrillation for the first time and 2 patients(2, 4% )experienced worsened atrial fibrillation that obviously influenced haemodynamics;One patient(1, 2% )ex-perienced ventricular arrhythmias following the infective endocarditis, Conclusion Community - based rehabilitation and health management is of great significance for preventing and treating the long - term complications after prosthetic valve replacement.
