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应用机械瓣与生物瓣行三尖瓣置换术患者短期和长期生存率的比较

Short-term and long-term outcomes of tricuspid valve replacement with mechanical and bioprosthetic valves

摘要目的:探讨应用生物瓣和机械瓣行三尖瓣置换术患者的短期和长期生存率之间的差异。方法:回顾性连续入选北京安贞医院1993年11月至2018年8月期间273例接受三尖瓣置换术治疗的患者。比较置换机械瓣与生物瓣患者的短期和长期生存率。结果:应用机械瓣行三尖瓣置换术的患者106例,应用生物瓣的患者167例,术后随访1~22年,随访(8.2±5.6)年。机械瓣组短期死亡16例(15.1%),生物瓣组短期死亡22例(13.2%),两组间差异无统计学意义( P=0.633)。机械瓣组1、5、10年生存率分别为81.9%、77.9%、75.5%,生物瓣组1、5、10年生存率分别为78.0%、73.1%、65.9%。 Kaplan- Meier生存曲线比较,两组长期生存率差异无统计学意义( P=0.234)。 结论:三尖瓣置换术的短期和长期病死率依然较高,但无论采用机械瓣还是生物瓣,两者的短期和长期生存率无显著差异。

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abstractsObjective:To investigate the difference between the short-term and long-term survival rates of patients undergoing tricuspid valve replacement with biological and mechanical valves.Methods:273 patients who received tricuspid valve replacement were selected from our Hospital from November 1993 to August 2018. The mean follow-up time was(8.2±5.6) years. The total follow-up rate was 95%. Kaplan-Meier method was used to make survival curves of the two groups and log rank test was used to compare the differences between the two groups. In addition, this study made the comparison of preoperative, intraoperative and postoperative information and long-term survival rate between these two groups.Results:There was no significant difference in demographic characteristics and baseline between mechanical valve group and biological valve group. 16 patients died in the mechanical valve group and 22 in the biological valve group. In the mechanical valve group, 14 cases died of postoperative low cardiac output syndrome and 2 cases died of gastrointestinal hemorrhage. 22 patients were died of low cardiac output syndrome. The auxiliary time in the mechanical valve group was longer than that in the biological valve group[(151.76±70.30)min vs.(131.62±60.25)min, P=0.013)]. There was no significant difference in long-term survival rate between the two groups in Kaplan- Meier survival curve( P=0.234). Conclusion:There is no difference in short-term and long-term survival rate between mechanical valve and biological valve in tricuspid valve replacement.

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