Добавил:
kiopkiopkiop18@yandex.ru t.me/Prokururor I Вовсе не секретарь, но почту проверяю Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз: Предмет: Файл:

Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_3906_Библиотеки_им_академика_М_И_Перельмана

.pdf
Скачиваний:
0
Добавлен:
10.10.2026
Размер:
8 Мб
Скачать
☆
   
100
 21.  -
  
     
    -
  «in situ».
   -
   ,
 -
  
 -
  
,   -
  -
 .   ,
   -
  -
     
      -
 Walter G. Wolfe (1980) ( 22) [285].
    
     «in situ»  -
       , 
       
     [15].
 22.      -
       
 4.    
    
101
    ,    -
     -
      -
 (, , ).
  Wolfe    
     
        -
 .
       
      -
     
   [16].
     
      
 .       ,  
     , -
     
     . 
     -
,        -
     , 
      
.
     ,
        
      -
      
 .
      -
      -
.      
      
   .    -
 ,  ,    -
.       -
     
    -
        -
   
102
     
.
     -
      -
    
.
 ,     -
  ,     -
  .    -  -
    .  -  
    
( 23).
 23.  . -   -
       -
  ,      
     .
      
-  ( 24).
 4.    
    
103
 24.  .  
 .    , -
 .
     
      -
     ,   -
    5/0 
6/0. ,     
      
   ,    
-      
( 25).
   
104
 25.  .  
.    ; -
      ; ,
       ;  -
  .
     
      
   26.
 26.   -
  
  -
   -
.
–  
  ,
 
    -
 ;
–  -  
,  -
  
   
   .
 4.    
    
105
 ,   
    
       
-  : 
    --
 .
     -
 .    
   -   -
;    
    ;  
  .
  ,       -
  ,   
 ,     , 
,     -
  .
     
       
 -  («Guidelines on the
management of valvular heart disease»),  European
Society of Cardiology  European Association for Cardio-Thoracic
Surgery [268].
       -
  ,   
 (- 
1
),   
    .
 ,    -
 ,   ≥45    
       -
,   ,   -
 ,    , 
      .
      -
      ,  
 ,    
      
1
 .
   
106
,      -
    .
     
  ,    -
,   ,     -
     .
4.3.  -
   
  
( )
      -
     -
  ,     -
     .
      -
        -
        -
 - ,   
      
      .
      
   , 
    -
    -
     ,  
       -
  -  (p<0,001;
=2,06; 95%: 1,45-2,93).
     
   .
     -
     -
     
      -
  - .
 4.    
    
107
     
      -
          -
  - ,  
      .
  :
–     (-
    );
–     
 -   
 (  ).
      -
        -
         
- ,   -
 ,     -
   .
     -
      -
 :
• наличие патологии аортального клапана как основной па-
,       
    ;
• отсутствие общепринятых показаний к реконструкции и/
  –   -
   (  ,  
    );
• наличие у больного описанных в литературе предикторов
    -
:
-   III ,
-   II ,
-   ,
-  ,
-   ;
• отсутствие анамнестических указаний на наличие пато-
     /   -
.
   
108
     -
  (  – 30 )
  (  25,0±4,1 ) -
    .
    -
       -
,    ,
  ,  
,     
     
.  ,     30
  :    
,     -
   ,    
     .
     -
 «»  «» -
,   ,   
    – 
       
  .
      
. -    
  -   ,
     
       -
.
 ,    ,
      2012 .   2013 .
     - 
       
 52 .
    54,1±11,2 . 
 42 (81%),  – 10 (19%).
   ,    -
,        -
        -
 -  III .
 4.    
    
109
-   -
     13.
 13.
-  
  (N=52)
Показатель Среднее значение 95% ДИ
  , /
2
28,0±4,1 26,9 – 29,1
  , 
2
1,9±0,2 1,8 – 2,0
   (),  39,9±7,3 37,9 – 41,9
   
  (), 
38,4±3,0 37,6 – 39,2
   -
   (), 
44,7±5,1 43,3 – 46,1
   
  
  (), 
32,6±2,6 31,9 – 33,3
       -
     14.
 14.
    
    (N=52)
Показание Количество пациентов
    28 (54%)
  

20 (38%)
  4 (8%)
ИТОГО 52 (100%)
    
   ,   
 - ,   
    , 
   ,
    -
.
     -
      15.