抗凝剂与 Björk-Shiley 人工心脏瓣膜。390 例患者的经验。
Anticoagulants and the Björk-Shiley prosthesis. Experience of 390 patients.
作者信息
Sutton M G, Miller G A, Oldershaw P J, Paneth M
出版信息
Br Heart J. 1978 May;40(5):558-62. doi: 10.1136/hrt.40.5.558.
From September 1972 to January 1975, 390 patients underwent valve replacement using the Björk-Shiley tilting disc prosthesis. For the group as a whole hospital mortality was 13.3 per cent and was lowest in those undergoing isolated mitral or aortic valve replacement (5.3 and 9.4%, respectively). Available for follow-up were 209 patients of whom 123 were maintained on dipyridamole and 96 on warfarin. Thromboembolic complications were significantly (P less than 0.01) commoner in the dipyridamole (28 of 123, 22%) than warfarin (6 of 86, 7%) treated group. In the dipyridamole treated group the incidence of thromboembolic complications was similar whichever valve was replaced and thromboembolic complications were responsible for 14 of the 28 late deaths. In the warfarin treated group thromboembolic complications only occurred in patients with a mitral prosthesis. Anticoagulation is indicated for all patients with this prosthesis wherever inserted.
1972年9月至1975年1月，390例患者使用Björk-Shiley倾斜碟瓣进行了瓣膜置换术。就整个组而言，医院死亡率为13.3%，在单纯二尖瓣或主动脉瓣置换患者中死亡率最低（分别为5.3%和9.4%）。有209例患者可供随访，其中123例服用双嘧达莫，96例服用华法林。双嘧达莫治疗组的血栓栓塞并发症（123例中有28例，22%）明显（P<0.01）比华法林治疗组（86例中有6例，7%）更常见。在双嘧达莫治疗组中，无论置换何种瓣膜，血栓栓塞并发症的发生率相似，28例晚期死亡中有14例归因于血栓栓塞并发症。在华法林治疗组中，血栓栓塞并发症仅发生在植入二尖瓣瓣的患者中。无论植入何处，所有使用这种瓣膜的患者均需抗凝治疗。
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