重症风湿性心脏病合并心脏恶液质的外科治疗

目的探讨并总结重症风湿性心脏病合并心脏恶病质患者围术期处理经验和特点，提高外科治疗的成功率。方法回顾性分析近5年54例心脏恶液质瓣膜患者的围手术期治疗。结果二尖瓣置换术17例，主动脉瓣及二尖瓣置换术35例，主动脉瓣、二尖瓣及三尖瓣置换术2例，同时行三尖瓣成形术52例，术后早期死亡4例（7．4％）。结论充分的术前准备、围术期营养支持，正确地选择好手术时机，加强术中处理，积极治疗术后并发症是提高手术疗效的关键。

The surgical treatment of the rheumatic valvular heart disease with cardiac cachexia

Objective To study the perioperative management in valvular disease associated with cardiac cachexia,in order that the success rate of surgical therapy of the disease will be increased. Methods During the last five years of 54 cases of rheumatic valvular disease with cardiac caehexia of being diagnosed on the basis of widely accepted definition were collected. Results 17 eases had mitral valve replaced, the other 35cases had both aortic and mitral valves replaced,2 eases had aortic,mitral and trieuspid valves replaced, and simultaneously 52 patients underwent the trieuspidoplasty too ,4 cases failed to survive（ mortality 7.4% ）. Conclusion Their nutrition and heart function must be improved in perioperatively. Aggressively treatment of postoperative complications is critical for the surgical results.