Bileaflet mechanical heart valves (BMHV) are clinically used to replace diseased heart valves. This study models the aortic root structure using medical imaging data and employs numerical simulations to analyse the hemodynamic characteristics of BMHV with different leaflet curvatures under pulsatile flow. Simulation results show that curved leaflets - by increasing the middle jet orifice area - improve the uniformity of three-jet flow distribution. Increasing leaflet curvature makes curved leaflets induce rotational fluid motion on their surface, causing more chaotic downstream vortex distributions but gradually reducing vortex intensity. With higher leaflet curvature, time-averaged wall shear stress (TAWSS) decreases, while oscillatory shear index (OSI) tends to increase in the ascending aorta. Regions with low wall shear stress (WSS) and high OSI usually have higher relative residence time (RRT), and transverse oscillatory shear index (OSItr) also decreases with increasing leaflet curvature. Thus, optimising mechanical valve leaflet design to improve hemodynamic performance can reduce postoperative complications.

The hemodynamic performance of prosthetic heart valves is critical to long-term postoperative outcomes. This study systematically compares the detailed flow field characteristics of aortic surgical bioprosthetic valves (SBV) and bileaflet mechanical heart valves (BMHV) under different physiological conditions, aiming to provide a fluid-dynamics-based rationale for personalized valve selection. An in vitro pulsatile left heart mock circulatory loop was established using a transparent silicone aortic root model reconstructed from the computed tomography data, with a refractive index-matched working fluid to eliminate optical distortion. Time-resolved particle image velocimetry was employed to quantify transient velocity fields, vortex evolution, and viscous shear stress (VSS) distributions downstream of both valve types under healthy, heart failure, and exercise conditions. The results show that the SBV consistently generates a broad, uniform, and stable central jet across all conditions, whereas the BMHV produces a characteristic triple-jet structure accompanied by pronounced wake separation. Under heart failure conditions, the low-velocity wake region downstream of the BMHV expands markedly, increasing the likelihood of flow stagnation. In contrast to the relatively stable vortex dynamics observed in the SBV, the BMHV induces strong shear layers and pronounced vortex shedding, particularly during late systole. Furthermore, the BMHV exhibits significantly higher VSS levels than the SBV in all cases, with a substantial increase under exercise conditions, suggesting potentially elevated risks of hemolysis and platelet activation. Overall, these findings indicate that the SBV provides more favorable hemodynamic performance, while the BMHV may be associated with increased risks of blood damage and thrombogenesis under specific physiological states.

When a bileaflet mechanical heart valve is surgically implanted into the body, the downstream left ventricular blood flow pattern becomes complex, which is directly related to many postoperative complications. To investigate the hemodynamic properties associated with mechanical heart valve design, we built a left heart circulatory pulsatile flow generation system to simulate left ventricular flow and pressure under physiological conditions. We used time-resolved particle image velocimetry to study left ventricular blood flow downstream of two types of bileaflet mechanical heart valve: one with planar leaflets and one with cambered leaflets. Blood flow downstream of two different bileaflet mechanical valve shapes was assessed. The experimental results show that the bileaflet valve with a triple-jet pattern creates a three-dimensional vortex ring with a complex topology. In addition, the robust jet mode can introduce high shear stresses into the ventricular blood flow. Compared with the planar valve, the jet produced by the cambered valve has a more uniform velocity distribution, its vortex structure moves farther, and its shear stress distribution is more straightforward and continuous. Furthermore, the channel formed between the cambered valve vortex structure and the left ventricle wall surface is highly favorable for scouring the apical position and facilitating the transport of blood to the aortic orifice. Therefore, the shape of the leaflets of a bileaflet mechanical valve can significantly impact the left ventricular blood flow pattern and the blood transport process. Rational optimization of the design of the leaflet shape and improvement of the mechanical valve’s hemodynamic characteristics can reduce complications after valve replacement.

Purpose: The implantation angle of Bileaflet Mechanical Heart Valve (BMHV) is critical issue in valve replacement surgery. Investigating the local hemodynamic characteristics and analyzing the postoperative flow dynamics can provide valuable insights for determining the optimal implantation angle, thereby offering clinical guidance for improved surgical outcomes. Methods: Three-dimensional anatomical model of the Left Ventricle (LV) and BMHV was reconstructed based on patient-specific medical imaging data and anatomical parameters. The hemodynamic effects of varying implantation angles were investigated using Computational Fluid Dynamics (CFD) integrated with a Fluid-Structure Interaction (FSI) framework. Results: The key analyses focused on the downstream shear stress distribution, vortex dynamics, clinically relevant hemodynamic indicators. When the valve was implanted along the axis of the aortic outflow tract (referred to as the AO angle), several benefits were observed. Blood flow penetrability improved, high shear stress regions were reduced, mechanical trauma to blood cells was significantly lessened. Quantitative metrics further demonstrated that the AO angle minimized values of Time-Averaged Wall Shear Stress (TAWSS), Oscillatory Shear Index (OSI) and Relative Residence Time (RRT). These metrics indicate more stable hemodynamics and a lower risk of ventricular wall inflammation and thrombosis. Furthermore, the Hemolysis Index (HI) reached its lowest level under the AO angle, suggesting optimal mitigation of hemolysis. This study systematically examines how the orientation of BMHV implantation affects LV hemodynamics. It identifies the AO angle as the most effective strategy for positioning. Conclusions: These findings provide quantitative evidence that can inform preoperative planning and support the advancement of precision-guided cardiac valve interventions based on hemodynamics considerations.

Background: To evaluate the clinical outcomes of sutureless aortic valve replacement (SUAVR) and transcatheter aortic valve implantation (TAVI). Methods: We systematically searched the electronic database and the Clinical Trials Registry up to 31 February 2023. Random effects model risk ratio (RR) and mean differences (MD) with corresponding 95% confidence intervals (CIs) were pooled for the clinical outcomes. Results: The included 16 studies using propensity-matched analysis consisted of 6516 patients, including 3258 patients in the SUAVR group and 3258 patients in the TAVI group. The SUAVR group had lower mortality than the TAVI group at 1-year [RR = 0.53, 95% CI (0.32, 0.87), I2 = 49%, p = 0.01], 2-year [RR = 0.56, 95% CI (0.37, 0.82), I2 = 51%, p = 0.03] and 5-year [RR = 0.56, 95% CI (0.46, 0.70), I2 = 0%, p < 0.01]. The SUAVR group had a significantly lower rate of new permanent pacemaker implantation (PPI) [RR = 0.74, 95% CI (0.55, 0.99), I2 = 48%, p = 0.04], moderate-to-severe paravalvular leak (PVL) [RR = 0.18, 95% CI (0.11, 0.30), I2 = 0%, p < 0.01], more-than-mild residual aortic regurgitation (AR) [RR = 0.27, 95% CI (0.14, 0.54), I2 = 0%, p < 0.01]. In addition, the SUAVR group had a higher rate of new-onset atrial fibrillation (AF) [RR = 3.66, 95% CI (1.95, 6.89), I2 = 84%, p < 0.01], major or life-threatening bleeding event [RR = 3.63, 95% CI (1.81, 7.28), I2 = 83%, p < 0.01], and higher postoperative mean aortic gradient [MD = 1.91, 95% CI (0.73, 3.10), I2 = 91%, p < 0.01] than the TAVI group. Conclusions: The early and mid-term clinical outcomes of SUAVR were superior compared to TAVI. Further studies should be conducted to highlight the specific subgroups of patients. that will benefit from each technique. INPLASY Registration Number: INPLASY 2022110058 (https://inplasy.com/inplasy-2022-11-0058/).

Based on Computed Tomography (CT) tomography images of the human heart, a 3D reconstruction and wall optimization of the heart was performed by using Mimics to model the motion of the left ventricular overflow wall. The non Newtonian blood flow in the left ventricle was numerically simulated using the dynamic mesh technique based on User Defined Functions UDF programming of the left ventricular wall motion. When the left ventricle is diastolic, the internal pressure gradually increases, the blood flow structure approximates the physiological blood flow pattern, the rate at the mitral orifice first increases and then decreases, and a local high stress zone appears. When the left ventricle is systolic, the pressure gradient is significant, the internal pressure decreases and the rate at the aortic valve orifice shows a pattern of increasing and then decreasing. The dynamic simulation of left ventricular blood flow provides a feasible technical solution for the fluid dynamics analysis of cardiac physiological and pathological processes.

Artificial heart valve replacement is recognized as the most effective method for treating valvular heart disease. Presently, the bileaflet mechanical heart valve is the predominant type utilized. Nonetheless, complications are known to arise following valve replacement surgery, mostly attributable to deviations in the left ventricular blood flow pattern instigated by the dysfunction of the bileaflet mechanical valve. However, the impact of mitral valve leaflet dysfunction on left ventricular hemodynamics has not been studied in depth. Hence, to approximate the physiological conditions of the left ventricular flow and pressure, a left heart circulation pulsatile flow system was devised. The time-resolved particle image velocimetry method was employed to evaluate the left ventricular blood flow under standard working conditions of the bileaflet mechanical valve and in the case where one of the valve leaflets is determined to be functionally impaired. The experimental results reveal that the normally functioning bileaflet valve manifests a tri-jet flow pattern, with intense jets on both sides generating two expansive vortices. Conversely, when one of the valve leaflets is impaired, the tri-jet flow metamorphoses into a bi-jet flow, coupled with augmented velocity. In both instances, the jets traverse along the ventricular model wall and alter their direction subsequent to passing the apex. Consequently, the employment of bileaflet valves culminates in a multifaceted left ventricular blood flow pattern. Furthermore, the valve leaflet dysfunction escalates shear stress, a condition that could potentially instigate damage to blood cells. The insights gained from this study can potentially guide the improved design of the mechanical bivalve.

Background: Congenital heart disease (CHD) is one of the most common birth defects and consumes a substantial amount of health care resources. CHD leads to heavy economic burdens for families. However, there are limited data regarding the utilization of healthcare resources for CHD. The objectives of this study were to evaluate the composition, changing trends, and factors affecting hospitalization costs for patients with CHD in the western highlands area of China over a 10-year period. Methods: We conducted a study using the International Quality Improvement Collaborative for Congenital Heart Surgery (IQIC) database and information management system of The First Hospital of Lanzhou University between January 2010 and December 2019. Results: Among 3,087 patients hospitalized for CHD surgery, annual CHD hospitalization costs saw an increasing trend over the 10-year period, with an average growth rate of 4.6% per year. The major contributors to the hospitalization costs were surgery, surgical material, and drug costs. Length of stay (β=0.203; 0.379; 0.474, P<0.01), age at hospitalization (β=0.293, P<0.01), proportion of surgery (β=0.090; –0.102; –0.122; –0.110, P<0.01) and drug costs (β=–0.114; –0.147; –0.069, P<0.01), and use of traditional Chinese medicine (β=0.141, P<0.01) were independent factors affecting average hospitalization costs. Conclusions: The financial burden of patients with CHD in the Chinese western highland region is high. Independent of inflation, CHD hospitalization costs are increasing. Measures taken by medical institutions to control the increase in drug costs, and to shorten the length of stay may be expected to have positive effects on reducing the financial burden of individuals with CHD and their families.

基于人体血液循环系统的基本生理学知识,确定人工心脏瓣膜脉动流实验系统的工作原理及设计方案.根据人体健康、运动、心衰三种生理状态下各种生理参数的范围,确定人工心脏瓣膜脉动流实验系统的设计要求及参数指标.依据血液循环系统主要组成部分的功能和特征以及流体力学相似性理论,设计脉动流模拟循环系统.将人体血液循环系统类比为流体系统,应用AMESim仿真软件搭建脉动流实验系统的等效流体系统模型,模拟健康、运动、心衰三种生理状态下的血流动力学特性,并将仿真结果与实验系统的关键参数指标,如左心室压力、主动脉压力及脉动血流量进行对比,分析在各种典型参数下得到的仿真结果是否与真实人体生理参数吻合,以此验证人工心脏瓣膜脉动流实验系统设计的合理性.

心脏脉动流实验系统是为了模拟人体血液循环系统而搭建的实验台.模拟心脏脉动流要求驱动机构能产生脉动的运动规律,其可以通过使用直线驱动元件带动活塞运动,从而使密闭水箱中的硅胶心脏模型压缩与舒张,由此来模拟心脏腔室内的血流脉动规律.根据实验台循环系统对驱动电机的结构要求及控制要求,提出利用有限元分析法建立R-Z轴模型设计驱动直线电机,解决现有驱动直线电机不能同时满足垂直方向行程大、灵敏度高、推力大的问题.提出基于粒子群算法智能参数整定的反馈+二阶前馈复合控制算法,解决了其他同类型实验台控制精度低、PID调参难、与生理曲线差别大的问题,达到了较好模拟真实心脏腔内血流流量和压力曲线的目的.

Background Although subclinical hypothyroidism (SCH) is related to abnormalities in left ventricular diastolic function, the use of levothyroxine as a regular treatment remains debatable. This meta-analysis aimed to determine whether thyroid hormone replacement therapy affects cardiac diastolic function in patients with SCH as measured by echocardiography. Methods This meta-analysis included a search of the EMBASE, PubMed, Web of Science, and Cochrane Library databases from their inception to May 18, 2023, for studies analyzing cardiac morphology and functional changes in patients with SCH before and after thyroid hormone replacement. The outcome measures were cardiac morphology and diastolic and overall cardiac function, as assessed using ultrasound parameters (including ventricular wall thickness, chamber size, mitral wave flow, tissue Doppler, and speckle tracking). The quality of the studies was assessed using the Newcastle–Ottawa Scale. The standard mean differences (MDs) and 95% confidence intervals (CI) were calculated using fixed- or random-effects models. Results Seventeen studies met the inclusion criteria. A total of 568 patients participated and completed the follow-up. All studies specifically stated that serum thyrotropin levels returned to normal by the end of the study period. Compared with baseline levels, no significant morphological changes were observed in the heart. In terms of diastolic function, we discovered that the ratios of E-velocity to A-velocity (E/A) had greatly improved after thyroid hormone replacement therapy, whereas the ratios of the mitral inflow E wave to the tissue Doppler e’ wave (E/e’) had not. Global longitudinal strain (GLS) increased significantly after treatment with levothyroxine. Conclusion In adult patients with SCH, thyroid hormone supplementation can partially but not completely improve parameters of diastolic function during the observation period. This meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement, an updated guideline for reporting systematic reviews (11) and was registered with INPLASY (INPLASY202320083). Systematic review registration https://inplasy.com/inplasy-2023-2-0083 .

Review question / Objective: P:Subclinical Hypothyroidism(Age over 18); I:thyroid hormone replacement therapy; C:baseline(before-after study in the same patient); O:Cardiac diastolic function measurement by echocardiography. Condition being studied: Subclinical hypothyroidism is associated with anomalies left ventricular diastolic functions, however, there are still disputes about whether to use levothyroxine for treatment. This meta-analysis aimed to determine whether levothyroxine (LT4), commonly used to treat hypothyroidism, affects cardiovascular indices in SCH patients as measured by echocardiography.

BACKGROUND:The CL-V full-carbon bileaflet mechanical heart valve is a novel Chinese-made prosthetic valve. This study evaluated the mid-term outcomes of the CL-V bileaflet mechanical heart valve after implantation in Chinese patients. METHODS:This study retrospectively enrolled a total of 38 consecutive patients who underwent elective mechanical heart valve replacement (MHVR) with two different valve types from April 2004 and May 2010, including 18 patients with the CL-V bileaflet mechanical heart valve (44.4% male, mean age 47.4±6.2 years, mean body weight 64.7±11.9 kg) and 20 patients with the St. Jude mechanical heart valve (45.0% male, mean age 49.7±7.6 years, mean body weight 66.1±11.1 kg). All patients underwent follow-up clinical evaluations in the outpatient department at all-time points. RESULTS:No complications occurred during the mean 61.3 months follow-up time (range, 47-102 months). The cardiothoracic ratios (52.7%±4.5% vs. 50.1%±4.0%), left atrium diameter (46.5±7.6 vs. 44.8±9.3 mm), left ventricular diastolic diameter (47.6±4.9 vs. 48.2±8.5 mm) and left ventricular ejection fraction (65.4%±8.7% vs. 64.5%±8.0%) were not significantly different between the two groups (P>0.05). Transthoracic Doppler echocardiography showed that the hemodynamic indexes were not significantly different between the two groups at 1 year and 3 years (P>0.05). Furthermore, no significant differences were found between the two groups in hemocompatibility indexes at both 6 months and 3 years postoperatively (P>0.05). CONCLUSIONS:The mid-term follow-up results of the CL-V bileaflet mechanical heart valve were similar to those of the St. Jude Medical heart valve, which showed stable hemodynamics and good blood compatibility. Chinese-made CL-V bileaflet mechanical heart valves can be a substitute for St. Jude Medical heart valves, and can be widely used in cardiac surgery. TRIAL REGISTRATION:Chinese Clinical Trial Registry ChiCTR2000034158.

Objective:To understand the distribution characteristics of pulse oxygen saturation (SpO 2) in the high altitude areas. Methods:From September 2016 to December 2017, all healthy and full-term live births in the First Hospital of Lanzhou University and Dunhuang, Jiuquan, Jingning and Lintao branches were selected as the research objects.Critical congenital heart disease or pulmonary diseases were excluded in advance.SpO 2 in different parts of newborns within 12 hours of birth was measured.Statistical comparisons of SpO 2 in different parts of male and female neonates in the same area and SpO 2 in different parts of different regions were made.The number of SpO 2 and the distribution of percentile difference between the lower limbs and the right upper limb of newborns at different altitude areas were obtained. Results:There were no significant difference between male and female infants in SpO 2 value at any lo-wer extremity and right upper extremity and the difference value in the same area (all P>0.05). There were significant differences in the median ( M) values of SpO 2 and the M value of the difference between the two values of any lower limb and right upper limb at different altitudes (all P<0.05). The results showed that the M value of SpO 2 of the right upper limb ( M=96%) in Lanzhou (1 520 m above sea level) was lower than that in Dunhuang (1 138 m above sea level, M=97%) and Jiuquan (1 481 m above sea level, M=97%), and the M value of the difference between the two values ( M=2%) was higher than that in Dunhuang and Jiuquan ( M=1%) ( P<0.05). The M of SpO 2 of any lower limb ( M=96%) and right upper limb ( M=96%) in Jingning areas (1 668 m above sea level) were lower than that in Dunhuang and Jiuquan area (all P<0.05). The median value of SpO 2 of any lower limb ( M=96%) and right upper limb ( M=96%) in Lintao area (1 883 m above sea level) was lower than that in Dunhuang and Jiuquan areas, and the M value of the difference between the two values ( M=2%) was higher than that in Dunhuang and Jiuquan (all P< 0.05). When the altitude was lower than 1 500 m, the M value of SpO 2 was 97%, P3- P97 was 93%-100%; the M value of the difference between any lower limb and right upper limb was 1, and P3- P97 was 0-4.When the altitude was higher than 1 500 m, the M value of SpO 2 was 95%-96%, P3- P97 was 89%-100%; the M value of SpO 2 of an lower limb and right upper limb was 1%-2%, and P3- P97 was 0-9%. Conclusions:The SpO 2 number and percentage distribution of the difference between any lower limb and right upper limb of newborns at different altitudes are different.

Objective To assess different bridging anticoagulation therapies early after mechanical heart valve replacement (MHVR) in Chinese patients. Methods We performed a prospective, single-center, observational cohort study of 305 patients who underwent elective MHVR with different bridging anticoagulation regimens. Patients enrolled in the study were divided into three bridging therapy groups: the unfractionated heparin (UFH) group ( n = 109), the low-molecular-weight heparin (LMWH) group ( n = 97), and the UFH with sequential LMWH (UFH-LMWH) group ( n = 99). All patients were followed for 4 weeks. Results Two patients experienced thromboembolic stroke events in the UFH group. The LMWH group was associated with an increase in the incidence of bleeding events compared with the UFH group (10.3% VS 2.8%; P = 0.03). With a comparison of LMWH and UFH group in secondary endpoints, the statistical test for significance indicated a trend of reduced ICU length of stay ( P = 0.08), postoperative length of stay (P = 0.08) and time of achieving target INR ( P = 0.06). The creatinine level (odds ratio = 1.03; 95% confidence interval = 1.01 to 1.05; P = 0.02) and hypertension (odds ratio = 3.72; 95% confidence interval = 1.35 to 10.28; P = 0.01) were risk factors for bleeding events. Conclusion For Chinese patients, the LMWH bridging anticoagulation presents the increased the incidence of bleeding events, but enables patients to benefit from achieving an early anticoagulation effect. Close follow-up and personalized management are required in patients with thromboembolic and bleeding risk factors. Trial registration Chinese Clinical Trial Registry ChiCTR1800019841 . Registered 2 December 2018 retrospectively.

Objective: To evaluate the efficacy and safety of different bridging anticoagulant therapies in patients undergoing mechanical heart valve replacement (MHVR) surgery. Methods: Consecutive patients undergoing MHVR surgery from January 2018 to December 2018 in First Hospital of Lanzhou University were prospectively enrolled in this study. Patients were divided into unfractionated heparin (UFH) group and low molecular weight heparin (LMWH) group according to the postoperative bridging anticoagulation methods. Preoperative clinical data and postoperative related time and cost parameters, including drainage time, duration of stay in intensive care unit (ICU), postoperative time (interval from end of operation to discharge) and INR stabilization time (interval from start of bridge anticoagulation to INR value reaching the standard for 2 consecutive days) of all enrolled patients were collected, and all patients were followed up for 4 weeks and thromboembolic or bleeding events were analyzed. Multivariate logistic regression was used to determine the independent prognostic factors of thromboembolic or bleeding events after MHVR receiving various bridging anticoagulant therapies. Results: A total of 217 patients were included in the study, including 120 patients in the UFH group and 97 patients in the LMWH group. Stroke occurred in two patients in the UFH group, while no stroke event occurred in the LMWH group. The incidence of bleeding events was significantly higher (9.28%(9/97) vs. 1.67%(2/120), P=0.02), while the drainage time, duration of stay in ICU, postoperative time, INR stabilization time were all significantly shorter in LMWH group than in UFH group (all P<0.05). Multivariate logistic regression analysis showed that bridging anticoagulation therapies (OR=0.18, 95%CI 0.04-0.86, P=0.03), fibrinogen level (OR=1.99, 95%CI 1.16-3.41, P=0.01) and creatinine level (OR=1.05, 95%CI 1.01-1.08, P=0.04) were independent prognostic factors for bleeding events. Conclusion: LMWH use is associated with increased risk of bleeding events, but can significantly reduce the drainage time, duration of stay in ICU, postoperative time, INR stabilization time in patients post MHVR surgery.

Objective To estimate the direct medical costs of inpatients with congenital heart disease(CHD)and reveal the time trend. Methods The CHD inpatients were investigated about medical expenses in the First Affiliated Hospital of Lanzhou University 2011-2015.Structural change degree was used to analyze the change in the structure of each expense. Results The average annual hospitalization cost was positively correlated with year(P <0.05)in simple CHD, composite defect and complex CHD.The average annual hospitalization cost of patients with complex CHD was (49 379.5 ±11 224.5)Yuan/Year which was higher than that of simple CHD](34 528.8 ±6 576.8)Yuan/Year] (P<0.05);Treatment costs share the largest proportion in the total medical costs despite the type of CHD, which was 28.1%,32.1% and 32.3% in simple CHD, composite defect and complex CHD respectively.With the respect of structural changes in various hospitalization expenses, the contribution rate of drug costs was the largest, which was 49.6%,49.3%and 38.1%in simple CHD,composite defect and complex CHD respectively,and showed a positive trend during 2011-2015.The contribution rate of blood costs varied most which was 16.4%and 20.6%with of composite defect and complex CHD respectively,and showed a negative trend during 2011-2015. Conclusion The direct disease burden of patients with complex CHD is heavy and showed increasing trend recently.Drug costs,treatment costs and material costs was the major factors influencing hospital costs.To relieve the disease burden of patients with CHD, multiple resources would be considered to increasing funding and to expand the scope of medical assistance for CHD.

目的 分析先天性心脏病(先心病)住院患者的直接经济负担及可能影响住院费用的主要因素,为制定相关卫生经济决策、降低疾病经济负担提供科学依据.方法 摘录2011-2015年兰州大学第一医院心外科收住的所有先心病患者的病案资料,对先心病患者的住院费用及相关因素进行通径分析.结果 2011-2015年兰大一院心外科收住先心病住院患者2 397例,平均住院时间为16.29 d,次均住院费用、日均住院费用分别为36 301.47、2 218.43元.秩相关分析结果表明先心病住院患者的次均住院费用、日均住院费用均呈逐年增加趋势(rs=0.900,P＜O.05).费用构成中,治疗费、药品费、材料费位居前3位,其构成比分别为29.07％ 、25.84％、24.91％.通径分析结果显示,影响住院费用的各因素按总效应大小依次为药费所占比例、住院天数、材料费所占比例、手术费所占比例、疾病分类、有无并发症、年龄别.结论 药品费、住院时间、材料费、手术费、疾病类别、并发症、年龄是影响先心病患者住院费用的主要因素;加强产后小儿体检,早期诊断,选择合适的手术时机早期治疗,控制药品费和材料费,预防术后并发症对减轻先心病患者和家庭的精神及经济负担有积极作用.

Hybrid operating room refers to clean operating rooms equipped with advanced MRI(magnetic resonance ima-ging), DSA(digital subtraction angiography) and CT(computer tomography), radiation therapy C-arm and navigation equip-ment.Currently, hospitals attach great importance to install and use DSA, so that the doctor can not only perform the conven-tional operation, but also directly explore the angiograpic and interventional therapy, which greatly improve the efficiency and the success rate of the surgery.After check out database, choosen about 40 papers of high quality.This paper introduces the concept of hybrid operating room, the development process, clinical application status and advantages in cardiovascular dis-ease, and prospects for its development in the future , and provides some suggestions to more easily build hybrid operating room.