心内直视手术后持续血红蛋白尿的治疗和预防

本文对11例心内直视术后持续性血红蛋白尿(Sustained Hemoglobinuria,SHbU)治疗结果进行了分析。结果表明,保守治疗4例;血红蛋白尿2～3d消失2例,死亡2例;7例再手术:痊愈4例好转1例,死亡2例,死亡率36.4％(4/11)。作者认为,患者术后仍有异常心脏杂音,甚至伴有震颤是SHbU的重要诊断依据;彩色多普勒超声心动图检查有助于诊断和指导手术探查。适时再次手术是最有效的治疗方法。

Treatment and Prevention of Sustained Hemoglobinuria Following Open Heart Surgery

This article reports on our experience in the treatment of 11 patients with sustained hemoglobinuria (SHbU) following open heart surgery. Four patients received conservative treatment, with subsequent disappearance of the sign within 2-3 days and 2 died early postoperatively. Reoperation was performed on seven patients, of whom 4 recovered completely, 1 improved significantly, and 2 died at surgery with a mortality rate of 36.4 % (4/11). The authors are of the opinion that postoperative murmur, accompanied by thrills, is an important diagnostic criterion for SHbU, and that echocardiography proves of value in its diagnosis and surgical treatment. In addition, appropriate reoperation remains the most effective treatment for SHbU following open heart surgery.