【摘要】 目的:比较风湿性瓣膜病二尖瓣与主动脉瓣双瓣置换术治疗风湿性瓣膜病的临床效果。方法:以2015年1月至2018年10月期间,粤北人民医院收治的198例风湿性瓣膜病患者为研究对象,对患者的临床资料进行回顾性分析,患者均行双瓣替换术治疗。其中二尖瓣与主动脉瓣联合病变102例,合并三尖瓣功能性关闭不全84例,三尖瓣器质性病变12例。所有患者均采用二尖瓣联合主动脉瓣病变置换术。随访患者1年观察临床长期效果。结果:198例患者术后早期(随访3个月)死亡患者19例(9.60%),其中双瓣手术后早期死亡率15例(7.58%),术后晚期(随访1年)死亡31例(15.66%)。死亡原因:心力衰竭、多器官功能衰竭、肝肾呼吸功能衰竭等。术后6个月和12个月的存活率分别为154例(77.78%)和142例(71.72%)。结论:风湿性瓣膜病变患者采用二尖瓣与主动脉瓣膜病变进行替换手术为主,能明显稳定患者长期疗效,提高患者疾病的存活率。更多还原

【Abstract】 Objective To compare the clinical effect of mitral valve replacement and aortic valve replacement for rheumatic valvular disease. Methods from January 2015 to October 2018, 198 patients with rheumatic valvular disease admitted to the people’s hospital of north guangdong province were studied. The clinical data of the patients were retrospectively analyzed, and all patients were treated with double valve replacement. There were 102 cases of mitral and aortic valve combined lesions, 84 cases of tricuspid functional insufficiency, and 12 cases of tricuspid organic lesions. All patients underwent mitral valve combined aortic valve replacement. Patients were followed up for 1 year to observe the long-term clinical effect. Results in 198 patients, 19(9.60%)died in the early postoperative period(followed up for 3 months), among which 15(7.58%) died in the early postoperative period after double-valve surgery, and 31(15.66%) died in the late postoperative period(followed up for 1 year). Causes of death: heart failure, multiple organ failure, liver, kidney and respiratory failure. The surial rates at 6 and 12 months were 154(77.78 %) and 142(71.72 %), respectively. Conclusion mitral and aortic valvular replacement surgery is mainly used in patients with rheumatic valvular disease, which can significantly stabilize the long-term efficacy of patients, improve the survival rate of patients, and has positive promotion value.更多还原