46例危重心脏瓣膜病的手术治疗及并发症分析

目的探讨危重心脏瓣膜病手术治疗和围手术期处理的经验。方法46例危重心脏瓣膜病患者接受二尖瓣置换术（MVR）27例，二尖瓣并主动脉瓣置换术13例，主动脉瓣置换术（AVR）6例；同时行三尖瓣环缩术12例，左房折叠术11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7例，其中室性心律失常2例、术后脑出血1例、多器官功能衰竭（MSOF）4例。结论危重心脏瓣膜病的外科治疗应注意围手术期处理，适当选择手术时机，合理纠正病变，加强术后并发症防治。

Analysis of surgical treatmeat and its complications in 46 cases with valvular heart disease

Objective To investigate the experience in surgical management and perioperation practice in critical valvular heart disease. Methods Of the 46 patients with severe valvular heart disease, 27 were performed with mitral valve replacement（MVR）, 13 were performed with mitral valve replacement plus aortic valve replacement, and 6 were performed with aortic valve replaeement（AVR）. Meanwhile, there were 12 patients with additional tricuspid annuloplasty and 11 patients with additional left atrial plieation. Results Early complications were ventriculax arrhythmia, hypokinemia, respiratory failure, and multisystem organ failure（MSOF）. 7 deaths aeeured early in postoperation. Among them, 2 died of ventricular arrhythmia, 1 died of cerebral hemorrhage, and 4 died of MSOF. Conclusion A great attention should be paid to administering the practice in perioperation period, making choice of time for operation, correcting pathological condition, and preventing and treating postoperative complications.