重症心脏瓣膜病的外科治疗

目的：总结重症心脏瓣膜病的外科治疗结果,探讨提高早期生存率的措施。方法：2005年1月至2009年12月我院共对41例重症心脏瓣膜病患者进行了换瓣手术。结果：术后早期死亡3例,1例死于低心排。1例于术后第9天突发室颤,抢救无效死亡。1例死于肾功能衰竭,余病例全部治愈出院。死亡率7.32%。随访35例,心功能Ⅰ级10例,Ⅱ级28例,Ⅲ级3例。结论：对重症心脏瓣膜病患者,充分的术前心功能调整,恰当选择手术时机,术中良好的心肌保护,尽量保留二尖瓣部分装置,术后严密的监护,加强术后并发症的防治,是提高手术成功率的关键。

The Surgery for Severe Valvular Heart Disease

Objective： To summary the surgical treatment of valvular heart disease.Method： From 2005.1 to 2009.12,A total of 41 patients in our hospital with severe heart valve disease underwent valve replacement surgery.Result： Early postoperative period,3 died,1 died of low cardiac output,1 case in the first 9 days after sudden ventricular fibrillation,died.1 patient died of renal failure,the others recovered and discharged.The mortality rate was 7.32%.Follow-up of 35 cases,10 cases of cardiac function grade Ⅰ,28 cases in grade Ⅱ,3 cases in grade Ⅲ.Conclusion： Patients with severe heart valves,heart function before full adjustment,proper choice of surgical time,intraoperative better myocardial protection,keeping mitral valve,some of postoperative intensive care,strengthen the prevention of postoperative complications is the key to improving success rate.