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分析
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摘要
目的剖析冠心病合并心脏瓣膜病行冠状动脉旁路移植联合心脏瓣膜置换术的临床疗效。方法方便选择2014年9月—2016年7月该院接诊的冠心病合并心脏瓣膜病患者74例,并将之以数字抽签的方式随机分成实验和对照两组(n=37)。其中,实验组采用冠状动脉旁路移植+同期心脏瓣膜置换术治疗方案,而对照组则实施冠脉支架植入联合非同期瓣膜置换术治疗。观察两组术后不良事件的发生情况,比较呼吸机应用时间等指标。结果实验组的不良事件发生率为13.51%,明显比对照组的51.35%低(P<0.05)。实验组的桥血管畅通率为97.30%,明显比对照组的81.08%高(P<0.05)。实验组的呼吸机应用时间为(62.79±13.42)d、住院时间为(12.86±2.45)d,均明显比对照组的(115.41±22.43)d、(26.37±5.28)d缩短(P<0.05)。结论积极采取冠状动脉旁路移植+同期心脏瓣膜置换术治疗方案,对冠心病合并心脏瓣膜病患者施以对症治疗,可显著缩短其呼吸机应用的时间,提高桥血管畅通率,减少不良事件发生风险。
Objective To analyze the clinical curative effect of coronary bypass grafting and homochronous cardiac valve replacement in treatment of coronary heart disease and valvulopathy.Methods 74 cases of patients with coronary heart disease and valvulopathy diagnosed in our hospital from September 2014 to July 2016 were conveniently selected and randomly divided into two groups with 37 cases in each,the experimental group were treated with coronary bypass grafting and homochronous cardiac valve replacement,while the control group were treated with coronary stent implantation and non-homochronous cardiac valve replacement,and the occurrence of postoperative adverse events of the two groups was observed and the application time of respirator was compared.Results The incidence rate of adverse reactions in the experimental group was obviously lower than that in the control group,(13.51% vs 51.35%)(P<0.05),and the patency rate of coronary bypass grafts in the experimental group was higher than that in the control group(97.30% vs 81.08%)(P<0.05),and the respirator application time and length of stay in the experimental group were obviously shortened compared with those in the control group,[(62.79±13.42)d,(12.86±2.45)d vs(115.41±22.43)d,(26.37±5.28)d](P<0.05).Conclusion The coronary bypass grafting and homochronous cardiac valve replacement in treatment of coronary heart disease and valvulopathy can obviously shorten the respirator application time,improve the patency rate of coronary bypass grafts and reduce the occurrence risks of adverse events.
Objective To analyze the clinical curative effect of coronary bypass grafting and homochronous cardiac valve replacement in treatment of coronary heart disease and valvulopathy.Methods 74 cases of patients with coronary heart disease and valvulopathy diagnosed in our hospital from September 2014 to July 2016 were conveniently selected and randomly divided into two groups with 37 cases in each,the experimental group were treated with coronary bypass grafting and homochronous cardiac valve replacement,while the control group were treated with coronary stent implantation and non-homochronous cardiac valve replacement,and the occurrence of postoperative adverse events of the two groups was observed and the application time of respirator was compared.Results The incidence rate of adverse reactions in the experimental group was obviously lower than that in the control group,(13.51% vs 51.35%)(P<0.05),and the patency rate of coronary bypass grafts in the experimental group was higher than that in the control group(97.30% vs 81.08%)(P<0.05),and the respirator application time and length of stay in the experimental group were obviously shortened compared with those in the control group,[(62.79±13.42)d,(12.86±2.45)d vs(115.41±22.43)d,(26.37±5.28)d](P<0.05).Conclusion The coronary bypass grafting and homochronous cardiac valve replacement in treatment of coronary heart disease and valvulopathy can obviously shorten the respirator application time,improve the patency rate of coronary bypass grafts and reduce the occurrence risks of adverse events.
引文
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[2]李伯海,赵永梅,梁荣鑫,等.冠状动脉旁路移植联合同期心脏瓣膜置换治疗冠心病合并心脏瓣膜病临床研究[J].中国医药科学,2016,6(24):172-174,189.
[3]陈磊,王霄霖,沈振亚,等.同期行冠状动脉旁路移植术及心脏瓣膜手术99例分析[J].浙江临床医学,2014(4):507-509.
[4]王燕.冠状动脉旁路移植同期行心脏瓣膜置换术的围手术期护理[J].浙江医学,2015(9):801-803.
[5]李细森,郑宝石.心脏瓣膜置换术同期行冠状动脉旁路移植术围手术期的护理[J].微创医学,2014,9(5):624-625,621.
[6]匡明星.冠状动脉旁路移植与同期心脏瓣膜置换术临床疗效探讨[J].中外医疗,2015(16):48-49.
[7]殷恩智,田伟臣,李刚,等.同期行冠状动脉旁路移植和心脏瓣膜置换术治疗冠心病合并心脏瓣膜病的临床研究[J].现代生物医学进展,2014,14(10):1890-1892.
[8]王伟玲.冠状动脉旁路移植同期瓣膜置换术的护理[J].全科护理,2011,9(32):2955-2956.