75岁以上老年患者瓣膜手术的临床特点及安全性

Bing Liu, Shengli Jiang, Lin Zhang
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摘要

目的探讨75岁以上老年人瓣膜手术的临床特点及手术条件。方法回顾性分析2014年1月至2019年1月我院75岁以上瓣膜手术患者的资料。共分析73例,占同期心脏瓣膜手术的5.3%(73/1 372)。男性46例,女性27例,平均年龄77.35岁(75 ~ 88岁)。主要诊断为MR 28例(38.3%)、MS 8例(11.0%)、AR 7例(9.6%)、AS+ AR 7例(9.6%)、AS 6例(8.2%)。MVR+ TVP 28例(38.4%),AVR 20例(27.4%),MVR 11例(15.1%)。2例(2.7%)患者安装起搏器,14例(19.2%)患者行冠状动脉旁路移植术。结果两组患者术前、术后左房舒张末期内径(LA)、左室舒张末期内径(LV)、右房舒张末期内径(RA)、射血分数(EF)在手术截流时间、体外循环时间、术后呼吸机时间、ICU时间、手术并发症、术后肝肾功能不全、死亡率等方面差异均有统计学意义(P < 0.05)。与150例60岁以下瓣膜手术相比(P>0.05)。结论二尖瓣反流是75岁以上老年患者最常见的瓣膜疾病,手术后心脏结构明显改善,手术风险与正常年龄组相同。因此,对于75岁以上的老年患者,瓣膜手术是安全的。关键词:老年阀;临床特点;手术;安全
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical characteristics and safety of valvular surgery in elderly patients aged over 75 years
Objective To study the clinical characteristics and surgical conditions of valve surgery in elderly patients over 75 years old. Methods Datas of patients over 75 years old with valve surgery in our hospital from January 2014 to January 2019 were retrospectively analyzed. 73 cases were analyzed, accounting for 5.3%(73/1 372) of the cardiac valve operations performed during the same period.There were 46 males and 27 females, with an average age of 77.35 years(75-88 years). The main diagnoses were MR 28 cases(38.3%), MS 8 cases(11.0%), AR 7 cases(9.6%), AS+ AR 7 cases(9.6%) and AS 6 cases (8.2%). There were 28 cases(38.4%) of MVR+ TVP, 20 cases(27.4%) of AVR, and 11 cases(15.1%) of MVR.Pacemakers were installed in 2 patients(2.7%) and coronary artery bypass grafting was performed in 14 patients(19.2%). Results There were statistically significant differences in left atrial end-diastolic diameter(LA), left ventricular end-diastolic diameter(LV), right atrial end-diastolic diameter(RA) and ejection fraction(EF) before and after surgery(P 0.05) in surgical interception time, extracorporeal circulation time, postoperative ventilator time, ICU time, surgical complications, postoperative liver and kidney functioninsufficiencyand mortality, as compared with 150 cases of valve surgery under 60 years old(P>0.05). Conclusion Mitral regurgitation is the most common valvular disease in senile patients over 75 years old, the cardiac structure is improved significantly after surgery, and the risk of surgery is the same as that in normal age groups. Therefore, valvular surgery issafe in elderly patients over 75 years old. Key words: Senile valve; Clinical characteristics; Surgery; Safety
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