动态心肌整形术改善了扩张心肌病患者的生存率
L F Moreira1, P Seferian, E A Bocchi
1Instituto do Coração Faculdade de Medicina, Universidade de São Paulo, Brazil.
Circulation
|November 11, 1991
概括
动态心肌整形显著改善存活率,并在患有严重心肌病的患者中逆转心力衰竭. 这种手术支持与单独的医学治疗相比,提供了更好的长期结果.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 心脏衰竭管理的管理
背景情况:
- 严重的心力衰竭,包括扩张性和沙加斯性心肌病,往往需要先进的治疗选择.
- 纽约心脏协会 (NYHA) 的III或IV级患者,尽管进行了最大限度的医疗治疗,但预后往往不好.
研究的目的:
- 调查动态心肌整形术作为严重心力衰竭的手术支持的疗效.
- 为了比较进行动态心肌整形手术的患者和接受医学治疗的患者之间的长期生存和功能结果.
主要方法:
- 研究了一组32名患有严重心肌病变的患者 (NYHA类III-IV).
- 15名患者接受了动态心肌整形手术,17名患者接受了传统医疗管理.
- 随访包括生存率,NYHA类评估,喷射分数和心肺运动测试.
主要成果:
- 1年和2年的精算生存率在心肌形成术患者 (78.7%,65.6%) 和医疗治疗患者 (41.1%,27.4%) (p=0.03) 中显著更高.
- 手术后左心室射出分数有所改善 (20.1%至26.8%,p<0.01),最大氧气消耗增加 (14.7至18.3毫升/公斤/分钟,p=0.01).
- 大多数幸存的心肌形成手术患者的情况有所改善,达到NYHA类I或II.
结论:
- 动态心肌整形是一种有效的治疗严重心力衰竭在患有扩张或查加斯性心肌病的患者.
- 该程序显示了长期生存和功能能力的显著改善.
- 手术干预为某些末期心力衰竭患者提供了一种优越的医疗管理替代方案.
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