223例缩窄性心包炎心包剥脱范围选择的临床研究

张建; 刘达兴; 梁贵友; 汤全; 王峰

doi:10.13201/j.issn.1001-1439.2018.04.013

223例缩窄性心包炎心包剥脱范围选择的临床研究

- 遵义医学院附属医院(贵州遵义, 563003)

详细信息

通讯作者: 刘达兴,E-mail:13639222003@163.com

中图分类号: R654.2

收稿日期: 2017-11-13

Clinical study of pericardial exfoliation range for constrictive pericarditis

- Department of Cardiovascular Surgery, Affiliated Hospital of Zunyi Medical College, Zunyi, 563003, China

More Information

Corresponding author: LIU Daxing, E-mail: 13639222003@163.com

Received Date: 13 November 2017

摘要

摘要: 目的:比较不同心包剥脱范围术后的疗效及优缺点, 为个体化手术治疗提供依据。方法:选取接受心包剥脱术的患者223例, 单因素分析术前风险因素。根据暴露风险因素定义低风险和高风险患者, 评价不同风险患者采取部分心包剥脱 (PP) 和全心包剥脱 (TP) 的围手术期风险及随访结果。结果:在低风险患者中, TP组与PP组手术时间、呼吸机辅助时间、ICU监护时间、心包纵膈引流量及术后并发症均差异无统计学意义, 两组均无死亡病例;在高风险患者中, TP组呼吸机时间和术后并发症高于PP组 (P＜0.05), 两组病死率的差异无统计学意义。短期随访结果提示, TP组术后左室射血分数及心功能改善优于PP组, TP组利尿剂依赖低于PP组 (均P＜0.05)。结论:TP术在低风险患者中不增加围手术期风险, 在高风险患者中不增加手术病死率, 更利于术后心功能恢复。
- 心包剥脱术 /
- 围手术风险 /
- 随访结果
Abstract: Objective: To assess effects, advantages and disadvantages of partial pericardiectomy (PP) and total pericardiectomy (TP) and provide scientific basis for patient-specific strategy.Method: A total of 223 patients who received pericardiectomy were included.Preoperative risk factors were analyzed by single factor analysis.Patients were defined as low risk and high risk based on exposure risk factors, and the perioperative risk and follow-up results between PP and TP were evaluated in these two types of patients.Result: In patients with low risk, there was no differences in the operation time, mechanical ventilation time, ICU monitoring time, pericardial effusion volume and postoperative complications between PP group and TP group.No death was found in both groups.In patients with high risk, the mechanical ventilation time and postoperative complications were higher in TP group than those in PP group (both P＜0.05), but there was no difference in the mortality rate between the two groups.Short-term follow-up suggested that the left ventricular ejection fraction and cardiac function were improved significantly better in TP group in patients with low risk, while diuretic were less used in TP group in patients with high risk (all P＜0.05).Conclusion: TP does not increase perioperative risk and surgical mortality, and is more conducive to recovery of heart function.
- pericardiectomy /
- perioperative risk /
- follow-up result

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