【摘要】 目的 :总结 76例双瓣膜替换术的经验。方法 :对 76例风湿性心脏病 ,联合瓣膜病患者施行双瓣膜替换术。术中对合并三尖瓣功能性关闭不全的患者施行Devega成形术。结果 :术后出现低心排综合征 7例 ,出血及心包填塞 5例 ,室性心律失常 6例 ,肾衰 3例 ,呼吸功能不全 4例 ,消化道出血及精神障碍各 2例。术后死亡 3例 ,死亡率 3 94% ,死亡原因分别是低心排 ,室性心律失常 ,肾功能衰竭。结论 :对联合瓣膜病变的患者 ,需加强围术期处理 ,术中强调平稳灌注 ,积极处理三尖瓣关闭不全 ,重症患者术中保留二尖瓣的瓣下结构可改进术后左心室的收缩功能更多还原

【Abstract】 Objective:To summarize the clinical experiences of double-valve replacement in 76 cases.Method:Double-valve replacement was operated on 76 rheumatic patients with multi-valve lesions.And the tricuspid valve regurgitation was treated by De-Vag procedure.Results:Postoperative complications were as follows:low cardiac output syndrome in 7 cases,bleeding and cardiac tamponade in 5 cases, ventricular arrhythmia in 6 cases, renal failure in 3 cases, respiratory insufficiency in 4 cases, hemorrhage of digestive tract in 2 cases, and psychonosema in 2 cases.Postoperative death occurred in 3 cases(3 94%) for low cardiac output,ventricular arrhythmia and renal failure.Conclusion:For the double-valve replacement patients the peri-operative treatment,excellent perfusion during operation,and complete correction of tricuspid valve regurgation should be emphasized.Retention of sub-mitral valve structure may improve left ventricular function especially for serious cases.更多还原