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[心脏瓣膜置换术后血液损伤的研究]

[Studies on blood traumatization following heart-valve prosthesis].

作者信息

Neef H, Fischer U, Panzner R

出版信息

Z Gesamte Inn Med. 1977 Mar 15;32(6):138-43.

PMID:868192
Abstract

In 47 patients blood traumatisation was checked after interventions on cardiac valves. The cases in question were: 34 implantations of valve prostheses, 10 valve reconstructions and 3 re-operations because of paravalvular leakages. The tested valve prostheses according to Starr-Edwards, Björk-Shiley and Beall revealed subclinical haemolyses of various degrees. In aortic position the values for Björk-Shirley prostheses showed advantages as compared to the Starr-Edwards valve. Of all tested valve types the Beall prostheses caused the highest blood traumatisation. Manifest haemolytic anaemia was found only in 3 cases, two of them showing paravalvular leakage. In the cases of double valve replacement performed with combined Starr-Edwards and Beall prostheses the haemolysis was only slightly higher than in cases of mitral valve replacement with Beall valves only. In three cases with paravalvular leakage the parameters of haemolysis increased very much, returning to normal in 2 patients after successful correction. The assessment of the parameters of blood traumatisation is indispensible for the choice and improvement of the different types of valves and essential for the diagnosis of paravalvular leakage as well as for the control after leakage repair.

摘要

对47例接受心脏瓣膜干预治疗的患者进行了血液损伤检查。这些病例包括:34例瓣膜假体植入、10例瓣膜重建以及3例因瓣周漏进行的再次手术。根据斯塔尔-爱德华兹(Starr-Edwards)、比约克-希利(Björk-Shiley)和比尔(Beall)设计的测试瓣膜假体显示出不同程度的亚临床溶血。在主动脉位置,与斯塔尔-爱德华兹瓣膜相比,比约克-希利假体的数值显示出优势。在所有测试的瓣膜类型中,比尔假体造成的血液损伤最大。仅在3例中发现明显的溶血性贫血,其中2例伴有瓣周漏。在用斯塔尔-爱德华兹和比尔假体联合进行双瓣膜置换的病例中,溶血程度仅略高于仅用比尔瓣膜进行二尖瓣置换的病例。在3例瓣周漏病例中,溶血参数大幅增加,2例患者在成功纠正后恢复正常。血液损伤参数的评估对于不同类型瓣膜的选择和改进是必不可少的,对于瓣周漏的诊断以及漏修复后的监测也至关重要。

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