心脏瓣膜置换术围手术期处理467例分析

目的:总结467例心脏瓣膜置换术围手术期处理经验.方法:收集我院1995年4月至2007年5月间实施心脏瓣膜置换手术的467例患者的临床资料,并对其进行回顾性分析.结果:449例患者安全度过围手术期,术后早期死亡18例,占3.85%.死亡原因主要为:严重低心排出量综合征、恶性心律失常、左心室后壁破裂,人工瓣心内膜炎,脑部并发症,呼吸功能或肾功能严重损害,凝血机制紊乱以及多脏器功能衰竭等.结论: 心脏瓣膜手术患者围手术期死亡及主要并发症的发生与术前心功能、术中心肌保护、手术方法的选择以及对一些并发症的治疗等有密切关系.

Perioperative Management of 467 cases Cardiac Valve Replacement

Objective: To sum up the experience in the perioperative management of cardiac valve replacement.Methods: From 1995 to 2007 the data of 467 patients underwent cardiac valve replacement in our department were reviewed.Results: 449 patients underwent perioperative period smoothly.18 patients died in the early stage of operation.The early mortality was 3.85%.The early death main reason were low cardiac output syndrome,ventricular arrhythmia,rupture of left ventricle,prosthetic valve endocarditis,respiratory and renal failure,and MODS.Conclusion: Reduction of operative complications lies on improvement in physical condition particularly in cardiac function,myocardial protection during the operation,decrease the time of aortic clamp and application of mild hypothermia heat-beating method.Furthermore,postoperative active treatment or prevention against low cardiac output syndrome,ventricular arrhythmia and multiple organ failure(MOF) should be emphasized.