| Objective:To investigate the early discomfort symptoms of patients after heart valve replacement and to provide the basis for futher exploration of the risk factors of postoperative discomfort symptoms.To investigate the quality of life of patients after heart valve replacement and explore its influencing factors,and to evaluate the efficacy of heart valve replacement surgery from the perspective of patients’ subjective and postoperative living status.The quality of life of patients after heart valve replacement was compared with that of the general population in Sichuan Province to provide reference for surgical choice of patients.It provides clinical basis for medical staff to give targeted intervention measures and improve the postoperative quality of life of patients at different time after operation.Method:The Cardiac Symptom Survey(CSS)was used to investigate the symptoms of patients with Cardiac valve replacement at 1 month,3 months and 6 months.The Short Form Health Survey(SF～36)was used to longitudinally and prospectively evaluate the quality of life of patients with valvular heart disease preoperatively,1 month,3 months and 6 months postoperatively.General,perioperative,and postoperative data that may affect patients’ quality of life were prospectively collected.Repeated measure analysis of variance or chi-square test was used to analyze the trend of quality of life and postoperative discomfort symptoms.One-way analysis of variance or independent sample t-test was used to analyze the effects of general information,perioperative period and postoperative related information on postoperative quality of life at different times.Significant variables of univariate analysis were included in the multiple linear regression model,and the factors influencing the quality of life of patients at different time points after surgery were analyzed by the multiple linear regression method.Result:The higher incidence of discomfort symptoms after heart valve replacement surgery is:pain and discomfort symptoms related to surgery,shortness of breath,fatigue,drowsiness,palpitation,sleep disturbance and so.The incidence of discomfort symptoms decreased significantly at 3 and 6 months after cardiac valve replacement(P<0.05).The preoperative quality of life of valvular heart disease patients was significantly lower than that of Sichuan general population except pain dimension(P<0.05).After heart valve replacement,the scores of bodily pain and role emotional decreased from the preoperative baseline level at 1 and 3 months,and returned to the preoperative baseline level at 6 months.The scores of other dimensions of quality of life were significantly improved from the preoperative baseline level at each time point after surgery.By 6 months after the operation,the quality of life of the patients in all dimensions was basically equivalent to that of the general population in Sichuan.Single factor analysis showed that farmer/individual,diabetes,preoperative left ventricular ejection fraction(LVEF)<50%,extracorporeal circulation time>150min,operation time>300min,LVEF<50%at 1 month after surgery,and postoperative pulmonary infection patients had worse quality of life at 1 month after operation(P<0.05).Multiple linear regression analysis displayed that farmer/individual and LVEF<50%at 1 month were risk factors for poor quality of life at 1 month after heart valve replacement.Univariate results indicated that preoperative LVEF<50%,mateless,operation time>300 min,LVEF<50%at 1 month and 3 month after surgery patients had worse quality of life at 1 month after operation(P<0.05).Multiple linear regression analysis illustrated that LVEF<50%at 1 and 3 months after surgery was a risk factor for poor quality of life at 3 months after heart valve replacement.Univariate analysis results demonstrated that age≥40 years,mateless and LVEF<50%at 6 months after operation patients had worse quality of life at 1 month after operation(P<0.05).Multiple linear regression analysis showed that age≥40 years and LVEF<50%at 6 months after operation were risk factors for poor quality of life at 6 months after heart valve replacement.Conclusion:There are a variety of uncomfortable symptoms in patients after heart valve replacement in the early stage.With the extension of postoperative time,the incidence of uncomfortable symptoms is gradually decreasing.Preoperative quality of life of patients with valvular heart disease is lower than that of the general population,and the quality of life is seriously impaired.The quality of life of patients with valvular heart disease is gradually improved and the cardiac function is gradually improved,which is similar to that of the general population,and the surgical effect was satisfactory.The factors that affect the quality of life of patients at different time points after heart valve replacement are different.Medical personnel should give targeted intervention measures at different time points to improve the quality of life of patients at various time points after surgery,so that patients are better able to their family and society. |
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