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feng shi xing xin zang bing shou shu qian hou fang chan fa sheng lv ji qi yu hou fen xi
Author(s): 
Pages: 89-91
Year: Issue:  S1
Journal: Academic Journal of Second Military Medical University

Keyword:  风湿性心脏病心房颤动预后;
Abstract: 目的:分析风湿性心脏病(风心病)手术前后房颤(Af)发生率及其预后。方法:回顾性分析1992~1994年561例风心病手术患者Af的发病率、死亡率及其相关因素。根据患者的病史、超声心动图、X线胸片、心电图、手术资料和术后6~40个月的随访结果进行分析。结果:风心病的Af发生率为65.24%,其中二尖瓣病变为75.26%,高于主动脉瓣病变的发生率(15.38%)。二尖瓣手术后Af持续的患者占93.89%,自然转为窦律者6.10%,术前窦律术后变为Af的占15.71%。二尖瓣手术后半年随访Af的发生率为80.09%。二尖瓣术后半年有28例行直流电转复,成功率为82.14%,与心胸比值、心衰持续时间、左房容积和左室容积有关。风心病中Af组的左房血栓检出率和脑栓塞发生率分别为7.65%和5.73%,显著高于窦律组。Af组的围术期和随访期死亡率分别为5.74%和3.28%,与窦律组无显著差别。结论:风心病伴慢性Af患者的术后Af自然转复律低,有80%经治疗后仍为Af持续状态。Af患者的血栓形成和栓塞发生率明显增高,心脏扩大和左心功能减退则影响Af的预后。
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