【摘要】 目的儿童心脏瓣膜疾病的外科处理,原则上应尽可能的采用修复技术进行治疗,但对瓣膜病变严重的患儿,则需行瓣膜置换术。本文旨在探讨儿童心脏瓣膜置换术的手术适应证,人工瓣膜的选择以及瓣膜置换术后长期抗凝等问题。方法总结43例16岁以下儿童瓣膜替换术的经验。结果全组长期存活41例,死亡2例,存活的41例中,除1例患儿发生右心室室壁瘤外,其余患儿心功能均恢复良好,无一例因生长发育出现心脏人工瓣膜相对狭窄及因抗凝引起的出血或血栓并发症。结论儿童人工心脏瓣膜置换术在慎重掌握手术适应证的基础上,有较好的临床效果。儿童心脏瓣膜置换应选择人工机械瓣膜。儿童瓣膜置换术后的抗凝需要经常定期地监测各项抗凝指标并随时做出适当的调整。更多还原

【Abstract】 Objective To evaluate the indications of operation, the choice of artificial heart valves and the postoperative anticoagulation treatment for heart valve replacement in the pediatric patients.Methods The clinical data of 43 pediatric patients who underwent heart valve replacement were reviewed. And the operation indications, artificial valves choice and anticoagulation treatment were analyzed.Results Forty-one cases got the long-term survival with an excellent NYHA function recovery except one who had a right ventricular aneurysm. No case suffered from the stricture in the artificial heart valves. No case had the bleeding or thrombus complications due to anticoagulation treatment.Conclusions The excellent clinical results can be gained in pediatric patients with heart valve replacement by selecting the rational cases, using greater types of mechanical valves and regularly monitoring the status of coagulation.更多还原