【摘要】 目的 探讨危重心脏瓣膜病手术治疗和围术期处理。方法 1991年10月—2003年12月危重心脏瓣膜病患者46例接受手术治疗,其中男21例,女25例;年龄28～65岁。术前心功能Ⅲ级22例,Ⅳ级24例。二尖瓣置换术15例,主动脉瓣置换术6例,二尖瓣加主动脉瓣置换术25例;同时行三尖瓣成形术38例,左房血栓清除术8例。结果 早期主要并发症为室性心律失常、低心排血量综合征、呼吸衰竭和多器官功能衰竭。早期死亡1例。结论 危重心脏瓣膜病的外科治疗应注重围术期处理,适当选择手术时机,合理纠正病变,加强术后并发症的防治。更多还原

【Abstract】 Objective To summarize the experience and the management of surgical treatment for critical cardiac valve disease during perioperative period. Methods 46 patients with critical cardiac valve disease from October 1991 to December 2003 underwent valve replacement. There were 21 males and 25 females, with an age range from 28 to 65 years old. Preoperative heart function of 22 cases was class Ⅲ ,and of 24 cases was class Ⅳ. Mitral valve replacement was performed in 15 cases; aortic valve replacement performed in 6 cases; both mireal and aortic valve replacement performed in 25 cases. Associated procedures were tricuspid annuloplasty in 38 cases, left atrium thrombectomy in 8 cases. Results Ventricular arrhythmia, low cardiac output, respiratory failure and multiple system organ failure (MSOF) were the most frequent early complications. Early death occurred in 1 case. Conclusion Surgical treatment for critical cardiac valve disease should perform followed measures, especially the management during perioperative period, choosing appropriately operative chance, correcting pathological changes, strengthening the prevention and the treatment of postoperative complications.更多还原