| 摘要: |
| 目的 探讨影响再次左房室瓣置换术患者早期及中期生存率的高危因素,为临床工作提供指导。方法 回顾性研究2005年1月至2010年12月间于长海医院胸心外科接受再次左房室瓣置换术的55例患者资料,对研究对象的生存率及其风险因素进行分析。对照组选自于我院进行首次左房室瓣置换术的患者,匹配性别、年龄、手术日期。通过单变量和多变量Cox回归模型分析患者术后30 d和3年生存率的危险因素。结果 再次左房室瓣置换术患者的术后30 d、1年、3年、5年生存率分别为92.7%、89.1%、83.6%、81.8%,与对照组(分别为94.5%、92.7%、90.9%、87.3%)之间差异无统计学意义。左室射血分数是影响再次左房室瓣置换术患者术后30 d生存率的独立危险因素(P=0.018,RR=15.33)；糖尿病(P=0.039,RR=6.242)和左室射血分数(P=0.001,RR=91.957)是影响术后3年生存率的独立危险因素。结论 再次接受左房室瓣置换术与第一次接受左房室瓣置换术相比,不增加患者早、中期死亡率；左室射血分数是影响再次左房室瓣置换术患者术后早期生存率的独立高危因素；糖尿病、左室射血分数是影响再次左房室瓣置换术患者术后中期生存率的独立高危因素。 |
| 关键词: 左房室瓣 心脏瓣膜假体植入 再手术 危险因素 |
| DOI：10.3724/SP.J.1008.2012.00633 |
| 投稿时间：2012-01-12修订日期：2012-05-28 |
| 基金项目: |
|
| Analysis of risk factors for second replacement of left atrioventricular valve |
| WU Jin-long△,YAN Tao△,ZOU Liang-jian*,TANG Hao,XU Zhi-yun |
(Department of Cardiothoracic Surgery, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
△Co-first authors.
*Corresponding author.) |
| Abstract: |
| Objective To assess the factors influencing the early and mid-term survival of patients receiving a second replacement of the left atrioventricular valve, so as to provide guidance for clinical practice. Methods We retrospectively analyzed 55 patients who underwent a second replacement of the left atrioventricular valve between Jan. 2005 and Dec. 2010 at Changhai Hospital. Their survival rate and its risk factors were analyzed. The control group included patients who received their first left atrioventricular valve replacement at the same hospital and had matched age, sex, and operation time. Univariate and multivariate Cox survival analyses were used to assess the survival risk factors at 30 days and 3 years after operation. Results The 30-day, 1-year, 3-year and 5-year survival rates of patients after reoperation were 92.7%,89.1%,83.6%,and 81.8%, respectively, which were not significantly different from those of the control group(94.5%, 92.7%, 90.9%, and 87.3%, respectively). The left ventricular ejection fraction was the only independent predictor of 30-day survival of patients after reoperation(P=0.018,RR=15.33). Diabetes mellitus and left ventricular ejection fraction were the independent predictors of 3-year survival (P=0.039,RR=6.242 and P=0.001,RR=91.957, respectively). ConclusionThe early and mid-term mortality rates are not significantly different between the first and second replacement of left atrioventricular valve. Left ventricular ejection fraction is the only independent predictor of early-term survival after re-replacement of left atrioventricular valve; diabetes mellitus and left ventricular ejection fraction are the independent predictors of mid-term survival. |
| Key words: left atrioventricular valve heart valve prosthesis implantation reoperation risk factors |
