心脏瓣膜置换术围手术期处理

目的　探讨心脏瓣膜置换术围手术期血流动力学变化及其手术处理方法。方法　选取 4 3例重症心脏瓣膜病患者 ,均为风湿性二尖瓣和 /或主动脉瓣病变 ,分别行单瓣或双瓣置换术。围手术期采用Swan Ganz四腔气囊漂浮导管监测中心静脉压、右房压、肺动脉压、肺毛细血管楔压 ,并计算心排血量、心脏指数和周围血管阻力。结果　 4 3例患者均安全度过围手术期 ,无早期死亡。结论　对重症心脏瓣膜病 ,维持血流动力学稳定和有效的心肌保护是围术期管理的关键。

Perioperative management of cardiac valve replacement

Objective To investigate the perioperative hemodynamics and operational management of cardiac valve replacement in the patients with severe cardiac valve disease.Methods 43 adult patients with severe cardiac valve disease underwent simple or double valve replacement.All patients were with rheumatic mitral valve disease and (or) aortic valve disease.Swan-Ganz catheter was used to monitor central venous pressure(CVP),right atrial pressure(RAP),pulmonary artery pressure(PAP),pulmonary capillary wedge pressure(PCWP),cardiac output(CO),cardiac index(CI),and systemic vascular resistance(SVR).Results 43 patients underwent perioperative period smoothly without early death.Conclusion The key of perioperative management of patients with severe cardiac valve diseases is maintenance of hemodynamics stability and effective myocardial preservation.