用机械或生物假肢替换大动脉门后患者假肢不匹配的临床影响
Milos Matkovic1,2, Nemanja Aleksic1,2, Ilija Bilbija1,2
1Department for Cardiac Surgery, Clinical Centre of Serbia, Belgrade, Serbia.
Texas Heart Institute journal
|October 23, 2023
概括
患者与假肢不匹配 (PPM) 是生物大动脉的常见现象,显著影响了生存率. 对于生物接收者来说,建议在手术期间避免PPM的策略.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 生物医学工程 生物医学工程
背景情况:
- 患者假肢不匹配 (PPM) 可能会对大动脉置换 (AVR) 后的结果产生负面影响.
- 在机械与生物AVR后,PPM对长期生存和生活质量 (QoL) 的影响需要进一步研究.
研究的目的:
- 评估患者的长期存活率和QoL进行AVR与或没有PPM.
- 为了比较PPM对接受机械与生物大动脉假肢的患者的影响.
主要方法:
- 分析了595名接受隔离AVR的患者队列.
- 根据假肢类型 (机械或生物) 和PPM的存在,患者被分为两层,计算使用有效孔面积和身体表面积.
- 在6年的随访期内评估了生存率和QoL.
主要成果:
- 中度至重度的PPM发生在69.8%的生物AVR患者和3.7%的机械AVR患者中.
- 与没有PPM (60.1个月;P=.04) 相比,患有PPM的生物学AVR患者的平均存活时间明显较短 (50.2个月).
- 在具有或没有PPM的机械AVR患者中没有观察到显著的生存差异 (P=.50),并且QoL得分在组之间没有差异.
结论:
- 在生物大动脉植入后,PPM是普遍存在的,并显著影响长期生存.
- 在植入生物假肢时,应考虑预防PPM的策略,特别是如果怀疑PPM.
- 在机械大动脉接收者中,PPM并没有显著影响生存率.
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