重症心脏瓣膜病的外科治疗

目的为探讨重症心脏瓣膜病外科治疗的安全性、手术成功率、治疗效果的方法。方法对200例重症心脏瓣膜病患者进行了手术治疗，按重症心脏瓣膜病的诊断标准，均存在多项心脏瓣膜病外科手术的高危因素；其中单纯左房室瓣替换94例、单纯主动脉瓣替换10例、左房室瓣替换加主动脉瓣替换90例、右房室瓣替换3例、感染性心内膜炎赘生物清除加左房室瓣替换3例，并且进行了回顾性的分析。结果本组手术大部分取得良好恢复，并发症发生率25％（50／200），术后早期死亡率7％（14／200）。随访157例中，远期死亡8例。结论重症心脏瓣膜病外科手术的卉度症发生率较高，手术风险相对较高，但术前准备、麻醉平稳、术中对病变的纠治合理和注意并发症的预防等，仍能取得较好的疗效。

Surgical treatment of severe valvular heart disease

Objective To study the safety,success rate and treatment effect of operative on severe valvular heart disease.Methods Operations had been performed in 200 cases of severe valvular heart disease.And there were some high risk factors in all cases evaluated by the diagnosis standard of severe valvular heart disease,including 94 cases of mitral valve replacement,10 cases of aortic replacement,90 cases of mitral replacement plus aortic replacement,3 cases of tricuspid replacement,3 cases of removing neoplasm caused by infective endocarditis plus mitral replacement.All the cases had been analyzed retrospectively.Results Most of the cases recovered well post-operation,but complication rate was as high as 25%(50/200),and the death rate was 7% in early stage.157 cases had been followed up,and 8 cases died in late stage.Conclusion The surgical complication and the operation risk of severe valvular heart disease is relative higher,but if pre-operation preparation,stable anesthesia,good protection of myocardium,proper treatment of the disease during operation,prevention of the complications have been taken attention to,the treatment effect is still good.