摘要
目的:观察冠状动脉旁路移植与心脏瓣膜置换术同期治疗冠心病合并心脏瓣膜病患者效果。方法:将88例冠心病合并心脏瓣膜病患者按照治疗方法分为观察组(n=44)和对照组(n=44),观察组实施冠状动脉旁路移植与心脏瓣膜置换术同期治疗,对照组为非同期实施,比较2组治疗效果、术中和术后情况、心功能、缺血情况。结果:观察组治疗总有效率高于对照组,观察组升主动脉阻断和呼吸机辅助、心肺转流术、ICU停留的时间均短于对照组;观察组术后3个月心胸比例、左室舒张末容积(LVEDV)、左室收缩末容积(LVESV)均低于对照组,左心室射血分数(LVEF)高于对照组;缺血持续时间短于对照组,缺血发生次数少于对照组,缺血总负荷低于对照组(均P<0.05)。结论:冠状动脉旁路移植与心脏瓣膜置换术同期治疗冠心病合并心脏瓣膜病患者效果优于分期手术,有利于围术期恢复,促进心功能恢复,改善缺血情况。
Objective:To observe the effect of simultaneous treatment of coronary artery bypass grafting and heart valve replacement on patients with coronary heart disease complicated with heart valve disease.Methods:Eighty-eight cases of the patients were divided into an observation group(n=44)and a control group(n=44)according to the treatment method.The observation group received simultaneous treatment of coronary artery bypass grafting and heart valve replacement surgery,while the control group received asynchronous treatment.The treatment effects,intraoperative and postoperative conditions,cardiac function and ischemia were compared between the two groups.Results:The total effective rate of treatment in the observation group was higher than that in the control group.The observation group had shorter duration of ascending aortic occlusion,ventilator assistance,cardiopulmonary bypass surgery,and ICU stay compared to the control group.The cardiothoracic ratio,left ventricular end diastolic volume(LVEDV),and left ventricular end systolic volume(LVESV)were all lower and the left ventricular ejection fraction(LVEF)was higher in the observation group than the control group three months after surgery.The duration of ischemia was shorter,the number of ischemic occurrences was less and the total ischemic load was lower in the observation group than the control group(all P<0.05).Conclusion:Simultaneous treatment of coronary artery bypass grafting and heart valve replacement for the patients is more effective than staged surgery,and is of benefit to perioperative recovery,promoting cardiac function recovery and improving ischemic conditions.
作者
袁超
王笑天
常峰荣
吕智超
YUAN Chao;WANG Xiaotian;CHANG Fengrong;LYU Zhichao(ICU of Cardiovascular Surgery,the Seventh People’s Hospital of Zhengzhou,Zhengzhou 450016,China)
出处
《上海医药》
CAS
2024年第19期48-51,共4页
Shanghai Medical & Pharmaceutical Journal
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
coronary heart disease
valvular heart disease
coronary artery bypass grafting
heart valve replacement
