【摘要】 目的总结重症瓣膜性心脏病患者行瓣膜置换术的围术期处理。方法回顾性分析52例重症瓣膜性心脏病行瓣膜置换术患者的临床资料。结果52例中,围手术期死亡9例(17.3%),包括室性心律失常3例,低心排综合征3例,肺部严重感染2例和肾衰合并弥散性血管内凝血(DIC)1例。发生严重并发症28例,其中,12例并发低心排综合征,15例发生急性肾衰,分别及时应用主动脉球囊反博和床旁血液透析后治愈;另有1例发生术后再出血,积极再手术止血后康复。结论良好的心肌保护以及加强围手术期处理是提高患者生存率的关键。更多还原

【Abstract】 Objective To summarize the perioperative management experience of valve replacement in the patients with severe valvular heart diseases.Methods Data of 52 patients with severe valvular heart diseases underwent mitral and/or aortic valve replacement were retrospectively analyzed.Results Nine cases died perioperatively,which included ventricular arrhythmia in 3 cases,low cardiac output syndrome in 3 cases,severe pulmonary infection in 2 cases,and renal failure complicated with DIC in 1 case.Severe complications occurred in 28 patients,in whom 12 cases occurred low cardiac output syndrome and 15 cases developed acute renal failure.All patients recovered well by timely managing with intra-aortic balloon pump and continuous renal replacement therapy,respectively.One case had postoperative rebleeding,who recovered after reoperation.Conclusion Sufficient cardial protection and enhanced perioperative management are critical for improving survival rate in the patients with severe valvular heart diseases.更多还原