期刊文献+

风湿性二尖瓣狭窄并发肺动脉高压患者二尖瓣置换术后早期临床转归分析 预览 被引量:10

Early outcome of mitral valve replacement in rheumatic mitral stenosis patients with pulmonary artery hypertension
在线阅读 免费下载
分享 导出
摘要 目的:分析风湿性二尖瓣狭窄患者二尖瓣置换术后的早期临床转归。方法:回顾分析128例因风湿性二尖瓣狭窄行二尖瓣置换术患者的临床资料,根据心脏彩超估测的肺动脉收缩压(SPAP)结果分为A组(30 mm Hg≤SPAP〈50 mm Hg,n=70)和B组(SPAP≥50 mm Hg,n=58),比较2组一般资料、手术相关资料、围手术期结果及早期随访结果。结果:2组间除SPAP、肺功能及右心室内径外,其余术前指标差异均无统计学意义。围手术期死亡5例,A组2例,B组3例。术后机械通气时间及ICU治疗时间B组均大于A组(P均〈0.05)。术后2组患者SPAP均较术前下降(P均〈0.05)。术后6个月复查心脏彩超显示2组病例人工瓣膜功能良好;A组SPAP升高至术前水平或以上患者2例,B组11例,2组相比,差异有统计学意义(χ2=7.644,P=0.006)。结论:二尖瓣狭窄患者的术前肺动脉压高增加了术后复发肺动脉高压的风险,早期临床转归也相对较差。 Aim: To analyze early outcome of mitral valve replacement in rheumatic mitral stenosis patients with pulmonary artery hypertension. Methods: A retrospective analysis of 128 rheumatic mitral stenosis patients with pulmonary artery hypertension received mitral valve replacement was performed. They were allocated into 2 groups according to SPAP:group A( 30 mm Hg≤SPAP 50 mm Hg,n = 70) and group B( SPAP≥50 mm Hg,n = 58). The general information,perioperative and postoperative data as well as the follow-up data were collected. Results: There were no significant differences in preoperative data except SPAP,pulmonary function or RVID between the 2 groups. In-hospital mortality was 5 in total,2 in group A and 3 in group B. The prolonged mechanical ventilation time and stay in ICU in group B were significantly longer than those in group A( P 0. 05). The SPAP declined after surgery in both groups. At 6 months after operation,the prosthetic valves all worked well; there were 2 patients' SPAP rising back to the level before surgery in group A and 11 in group B,and there was significant difference( χ2= 7. 644,P = 0. 006). Conclusion: The higher level of SPAP may increase the risk of SPAP rising after surgery,and result in worse early outcome.
作者 陈楠 朱耀斌 张伟华 罗鸿 马宁 刘东海 张新 乔晨晖 CHEN Nan, ZHU Yaobin, ZHANG Weihua, LUO Hong, MA Ning, LIU Donghai, ZHANG Xin, QIAO Chenhui (Department of Cardiovascular Surgery, the First Affiliated Hospital,Zhengzhou University, Zhengzhou 450052)
出处 《郑州大学学报:医学版》 CAS 北大核心 2016年第4期538-541,共4页 Journal of Zhengzhou University: Med Sci
关键词 风湿性心脏病 二尖瓣狭窄 肺动脉高压 二尖瓣置换术 rheumatic heart disease mitral stenosis pulmonary artery hypertension mitral valve replacement
作者简介 通信作者,男,1961年9月生,博士,教授,主任医师,研究方向:心脏大血管外科基础及临床应用,E-mail:qchenhui@hotmail.com
  • 相关文献

参考文献16

  • 1朱晓东主编..心脏外科学[M].北京:人民卫生出版社,2007:1299.
  • 2MONTANI D, GUNTHER S, DORFMULLER P, et al. Pulmonary artery hypertension [ J ]. Orphanet J Rare Dis, 2013,6(8) :97. 被引量:1
  • 3PARVATHY UT,RAJAN R, FAYBUSHEVICH AG. Pul- monary function derangements in isolated or predominant mitral stenosis-preoperative evaluation with clinico-hemody- namic correlation[ J]. Interv Med Appl Sci,2014,6(2) :75. 被引量:1
  • 4RASHID A, SATTAR KA, DAR MI, et al. Analyzing theoutcome of early versus prolonged extubation following car- diac surgery [ J ]. Ann Thorac Cardiovasc Surg, 2008, 14 (4) :218. 被引量:1
  • 5JOSKOWIAK D, WILBRING M, SZLAPKA M, et al. Read- mission to the intensive care unit after cardiac surgery: a single-center experience with 7105 patients [ J ]. J Cardio- vasc Surg(Torino),2012,53(5) :671. 被引量:1
  • 6TURGEMAN Y, ATAR S, ROSENFELD T. The subvalvular apparatus in rheumatic mitral stenosis: methods of assess- ment and therapeutic implications [ J ]. Chest, 2003,124 (5) :1929. 被引量:1
  • 7GANDHI H,SHAH B, PATEL R, et al. Effect of preopera- tive oral sildenafil on severe pulmonary artery hypertension in patients undergoing mitral valve replacement[ J]. Indian J Pharmacol,2014,46(3) :281. 被引量:1
  • 8GARCfA-FUSTER R, ESTEVEZ V, GIL O, et al. Mitral valve replacement in rheumatic patients: effects of chordal preservation [ J ]. Ann Thorac Surg, 2008,86 ( 2 ) :472. 被引量:1
  • 9徐敬,李金花,舒礼良.完全或部分保留二尖瓣及瓣下结构的瓣膜置换术20例体会[J].郑州大学学报:医学版,2003,38(6):984-984. 被引量:2
  • 10PANDE S, AGARWAL SK, DHIR U, et al. Pulmonary arte- rial hypertension in rheumatic mitral stenosis: does it affect right ventricular function and outcome after mitral valve re- placement? [ J]. Interact Cardiovasc Thorac Surg,2009,9 (3) :421. 被引量:1

二级参考文献93

  • 1杜军保,金红芳,唐朝枢.关注气体小分子在心血管疾病发病中的意义[J].中国循证儿科杂志,2006,1(2):86-88. 被引量:11
  • 2黄从新,马长生,杨延宗,黄德嘉,张澍,江洪,杨新春,吴书林,马坚,刘少稳,李莉,曹克将,王方正,陈新.心房颤动:目前的认识和治疗建议(二)[J].中华心律失常学杂志,2006,10(3):167-197. 被引量:245
  • 3Opitz CF,Ewert R. Dual ET( A)/ET(B) vs. selective ET(A) endothelin receptor antagonism in patients with pulmonary hypertension [ J ]. Eur J Clin Invest ,2006,36 ( suppl 3 ) : 1 - 9. 被引量:1
  • 4Jacobs A, Preston IR, Gomberg - Maitland M. Endothelin receptor antagonism in pulmonary arterial hypertension - a role for selective ET (A) inhibition [J] .? Curr Med Res Opin,2006,22(12) :2567 -2574. 被引量:1
  • 5McKinnon-RD, Waldron S, Kiel ME. PDGF aipha - receptor signal strength controls an RTK rheostat that integrates phos - phoinositol 3' - kinase and paospholipase C gamma pathways during oligodend rocyte maturation[ J]. J Neurosci ,2005,25 ( 14 ) :3499 - 3508. 被引量:1
  • 6Liu Y, Fanburg BL. Serotonin - induced growth of pulmonary artery smooth muscle requires activation of phosphatidylinositol 3 - kinase/sefine- threonine protein kinase B/mammalian target of rapamycin/p70 ribosomal $6 kinase 1 [ J ]. Am J Respir Cell Mol Biol, 2006,34 ( 2 ) : 182 - 191. 被引量:1
  • 7Nakanishi K, Osada H, Uenoyama M, et al. Expression of adrenomedullin mRNA and protein in rats with hypobaric hypoxia - induced pulmonary hypertension[ J]. Am J Physiol,2004,286(6) :2159 - 2168. 被引量:1
  • 8Gong LM, Du JB, Shi L, et al. Effects of endogenous carbon monoxide on collagen synthesis in pulmonary artery under hypoxia [ J ]. Life Sci,2004, 74(3) :1225 - 1241. 被引量:1
  • 9Foresti R,Hammad J,Clark JE ,et al. Vasoactive properties of GURM - 3 a novel water - soluble carbon monoxide -releasing molecule[ J]. Br J Pharmacol, 2004,142 ( 4 ) :453 - 460. 被引量:1
  • 10Dubuis E, Potier M, Wang R, et al. Continuous inhalation of carbon monoxide attenuates hypoxic pulmonary hypertension development presumably through activation of BKCa channels [ J ]. Cardiovasc Res, 2005,65 (7) :751 - 761. 被引量:1

共引文献8

同被引文献58

引证文献10

二级引证文献12

投稿分析

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部 意见反馈