摘要
目的探讨冠状动脉旁路移植同期行心脏瓣膜置换术治疗冠心病合并心脏瓣膜病的临床效果。方法选取2018年2月至2021年2月我院82例冠心病合并心脏瓣膜病患者,依据治疗方法将其分为同期组和分期组,每组41例。同期组接受冠状动脉旁路移植同期行心脏瓣膜置换术治疗,分期组接受冠状动脉旁路移植分期行心脏瓣膜置换术治疗。比较两组的临床效果。结果术后,同期组心功能分级Ⅰ级、Ⅱ级患者占比高于分期组,Ⅲ级、Ⅳ级患者占比低于分期组,差异具有统计学意义(P<0.05)。术后,同期组的左心室射血分数、左心室舒张末期前后径、心胸比高于分期组,左心室收缩末期容积、左心室舒张末期容积低于分期组,差异具有统计学意义(P<0.05)。同期组的治疗优良率高于分期组,差异具有统计学意义(P<0.05)。同期组的永久性起搏器置入率、瓣周漏率低于分期组,桥血管畅通率高于分期组,差异具有统计学意义(P<0.05)。术后,同期组的缺血发生次数少于分期组,缺血持续时间短于分期组,缺血总负荷及B型尿钠肽水平低于分期组,差异具有统计学意义(P<0.05)。结论冠状动脉旁路移植同期行心脏瓣膜置换术治疗冠心病合并心脏瓣膜病的效果显著,可改善患者的心功能,值得推广。
Objective To investigate the clinical effect of coronary artery bypass grafting and heart valve replacement at the the same period in the treatment of coronary heart disease complicated with heart valve disease.Methods Eighty-two patients with coronary heart disease complicated with heart valve disease in our hospital from February 2018 to February 2021 were selected and divided into same period group and stage group according to treatment method,with 41 cases in each group.The same period group received coronary artery bypass grafting and heart valve replacement at the the same period,and the stage group received coronary artery bypass grafting and heart valve replacement by stages.The clinical effects of the two groups were compared.Results After operation,the proportions of patients with cardiac function grade Ⅰ and Ⅱ in the same period group were higher than those in the stage group,the proportions of patients with cardiac function grade Ⅲ and Ⅳ were lower than those in the stage group,and the differences were statistically significant(P<0.05).After operation,the left ventricular ejection fraction,left ventricular end diastolic anteroposterior diameter and cardiothoracic ratio in the same period group were higher than those in the stage group,the left ventricular end systolic volume and left ventricular end diastolic volume were lower than those in the stage group,and the differences were statistically significant(P<0.05).The excellent and good rate of treatment in the same period group was higher than that in the stage group,and the difference was statistically significant(P<0.05).The permanent pacemaker implantation rate and perivalvular leakage rate in the same period group were lower than those in the stage group,the bridge vessel patency rate was higher than that in the stage group,and the differences were statistically significant(P<0.05).After operation,the number of ischemia in the same period group was less than that in the stage group,the duration of ischemia was shorter than that in the sta
作者
杨勇
彭岚刚
YANG Yong;PENG Langang(Cardiovascular Surgery Department,the First Affiliated Hospital of Air Force Military Medical University,Xi'an 710032,China)
出处
《临床医学研究与实践》
2021年第24期29-32,共4页
Clinical Research and Practice
基金
西安市科技计划项目[No.2019081046YX10SF14(14)]。
关键词
冠心病
心脏瓣膜病
冠状动脉旁路移植
心脏瓣膜置换术
心功能
coronary heart disease
heart valve disease
coronary artery bypass grafting
heart valve replacement
cardiac function
