重症瓣膜病的外科治疗

目的 为提高重症瓣膜病患者外科治疗的成功率, 总结及探讨其围手术期处理的特点。方法 回顾性分析2000年12月～2009年6月行外科手术治疗的276例重症瓣膜病患者资料，总结围手术期及随访情况。结果 62例术后出现并发症，术后住院期间死亡12例，死亡率为4.35%。失访12例，其余随访3个月～9年，死亡6例，其余患者恢复良好，心功能均恢复至Ⅰ～Ⅱ级232例，Ⅲ级8例，Ⅳ级6例。结论 充分的术前准备，围手术期营养支持，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。

Surgical treatment of severe valvular heart diseases

Objective      To investigate the experiences of perioperative and surgical treatment of severe valvular heart diseases. Methods     From Dec. 2000 to Jun 2009, 276 patients with severe valvular heart diseases underwent surgical treatment. The perioperative treatment and the follow up were observed. Results     There were 12 early operation related deaths and 62 patients with various post operative complications. The mortality was 4.35%. 12 patients were lost during follow-up. The rest of the patients showed clinical improvements during a follow up of 3 months to 9 years in which 6 patients died. The heart functions of 232 patients were class I - II. In another 8 and 6 patients, the heart functions were  class Ⅲ and Ⅳ, respectively. Conclusion     Patients with severe valvular heart diseases are susceptible to various complications after operation. Their nutrition and heart function must be improved perioperatively. Myocardial protection and  tricuspid treatment should be strengthened in operation. Treatment of postoperative complications is critical for a good prognosis.