中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2013年
1期
22-24
,共3页
心脏瓣膜病%心脏瓣膜假体植入
心髒瓣膜病%心髒瓣膜假體植入
심장판막병%심장판막가체식입
Heart value diseases%Heart value prosthesis implantation
目的 研究老年患者行心脏瓣膜置换术的治疗效果,总结手术治疗经验. 方法 回顾性分析2008年1月至2011年12月在我院行心脏瓣膜置换术的76例老年患者的临床资料及随访情况,分析手术方式的选择、一般效果、术后死亡和并发症情况、随访中患者生存率和生活质量. 结果 无术中死亡,术后早期病死4例,早期病死率为5.3％.术后31例出现并发症,发生率为40.8％,包括呼吸功能不全、肺部感染、心律失常、切口感染、胸腔积液、低心排血量综合征、肾功能不全等.随访时间为18个月至52个月,平均(24.7±3.6)个月.失访5例,随访率为93.4％.手术1个月后死亡6例,病死率7.9％.生存患者心功能得到不同程度的改善,最后1次随访结果心功能Ⅰ～Ⅱ级47例,Ⅲ级13例,Ⅳ级6例. 结论 正确判断手术适应证、充分做好术前准备、术中严谨操作并做好心肌保护、术后加强监护,有助于降低老年心脏瓣膜置换术患者的病死率,减少并发症.
目的 研究老年患者行心髒瓣膜置換術的治療效果,總結手術治療經驗. 方法 迴顧性分析2008年1月至2011年12月在我院行心髒瓣膜置換術的76例老年患者的臨床資料及隨訪情況,分析手術方式的選擇、一般效果、術後死亡和併髮癥情況、隨訪中患者生存率和生活質量. 結果 無術中死亡,術後早期病死4例,早期病死率為5.3％.術後31例齣現併髮癥,髮生率為40.8％,包括呼吸功能不全、肺部感染、心律失常、切口感染、胸腔積液、低心排血量綜閤徵、腎功能不全等.隨訪時間為18箇月至52箇月,平均(24.7±3.6)箇月.失訪5例,隨訪率為93.4％.手術1箇月後死亡6例,病死率7.9％.生存患者心功能得到不同程度的改善,最後1次隨訪結果心功能Ⅰ～Ⅱ級47例,Ⅲ級13例,Ⅳ級6例. 結論 正確判斷手術適應證、充分做好術前準備、術中嚴謹操作併做好心肌保護、術後加彊鑑護,有助于降低老年心髒瓣膜置換術患者的病死率,減少併髮癥.
목적 연구노년환자행심장판막치환술적치료효과,총결수술치료경험. 방법 회고성분석2008년1월지2011년12월재아원행심장판막치환술적76례노년환자적림상자료급수방정황,분석수술방식적선택、일반효과、술후사망화병발증정황、수방중환자생존솔화생활질량. 결과 무술중사망,술후조기병사4례,조기병사솔위5.3％.술후31례출현병발증,발생솔위40.8％,포괄호흡공능불전、폐부감염、심률실상、절구감염、흉강적액、저심배혈량종합정、신공능불전등.수방시간위18개월지52개월,평균(24.7±3.6)개월.실방5례,수방솔위93.4％.수술1개월후사망6례,병사솔7.9％.생존환자심공능득도불동정도적개선,최후1차수방결과심공능Ⅰ～Ⅱ급47례,Ⅲ급13례,Ⅳ급6례. 결론 정학판단수술괄응증、충분주호술전준비、술중엄근조작병주호심기보호、술후가강감호,유조우강저노년심장판막치환술환자적병사솔,감소병발증.
Objective To investigate the efficacy of heart value replacement on elderly patients and summarize the experience of surgical treatment.Methods The clinical data and follow-up status of 76 elderly patients were analyzed retrospectively in our hospital from January 2008 to December 2011.The operative method,general effect,postoperative death,postoperative complications,survival rate and life quality followed-up were analyzed.Results No intraoperative death appeared and there were 4 early operative deaths with a mortality rate of 5.3％.There were 31 cases occurred postoperative complication with a complication rate of 40.8％ which including respiratory insufficiency,lung infection,arrhythmia,incision infection,pleural effusion,low cardiac output syndrome and renal insufficiency.The follow-up time was 18-52 months and the mean follow-up time was (24.7± 3.6)months.There were 5 cases lost of follow up and the follow-up rate was 93.4％.There were 6 patients died after a month postoperative with a mortality rate of 7.9％.The heart function of the survivors achieved differed degree improvements and the result at the end of follow-up were grade Ⅰ-Ⅱ 47 cases,grade Ⅲ 13 cases and grade Ⅳ 6 cases.Conclusions To correctly determine the surgery indications,do all the preoperative preparation,intraoperative rigorous operating with a good myocardial protection and to strengthen the postoperative care will be help to reduce the mortality and complications of the elderly patients with heart value replacement.
