现代时代的狭窄性心膜炎:不断变化的临床谱和心膜切除术后结果的影响
1Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minn, USA.
Circulation
|September 29, 1999
概括
收缩性心膜炎 (CP) 的表现发生了变化,老年患者和辐射引起的病例正在增加. 心切除术的结果受到影响,特别是辐射诱导的CP,尽管手术可以改善大多数幸存者的症状.
科学领域:
- 心脏病学 心脏病学
- 胸部外科手术 胸部外科手术
- 医学成果研究研究成果
背景情况:
- 狭性心膜炎 (CP) 的病因因素已经演变,影响了临床表现和治疗结果.
- 在CP发病率的变化需要重新评估手术干预的有效性.
研究的目的:
- 评估不断变化的狭性心周炎 (CP) 病因因素对心周切除术结果的影响.
- 将当代CP患者的人口统计和结果与历史数据进行比较.
主要方法:
- 135名当代 (1985-1995) 狭性心膜炎 (CP) 患者与历史队列的回顾性比较.
- 术后死亡率,晚期存活率和术后心脏切除术后功能状态的分析.
- 循序渐进的物流回归以确定长期结果的独立预测因素.
主要成果:
- 当代的CP患者年龄较大 (中位数为61岁与45岁),由于心脏手术和中辐射,发病率增加.
- 术后死亡率显著下降 (6%vs. 14%),但10年晚期存活率低于一般人群 (57+/-8%).
- 年龄,NYHA类和后辐射导致独立预测的长期结果;83%的幸存者报告症状改善.
结论:
- 收缩性心膜炎 (CP) 的不断变化的特征,包括老年患者和辐射引起的疾病,显著影响心膜切除术的预后.
- 皮心切除术的长期结果对于某些群体来说是不理想的,特别是那些患有辐射引起的CP的人.
- 尽管存在挑战,但心周切除术在大多数长期幸存者中减轻或改善了症状.
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