37例重症心脏瓣膜病手术治疗体会

目的:总结重症心脏瓣膜病的外科治疗经验。方法:对2008年1月～2011年1月我科37例重症心脏瓣膜病患者的术前准备、手术方法和术后处理等外科治疗进行分析。结果:术后低心排15例,严重心律失常7例,肺部感染9例,肾功能衰竭3例,死亡3例,死因低心排2例,肾功能衰竭1例。29例术后随访,心功能Ⅰ级19例,Ⅱ级6例,Ⅲ级3例,Ⅳ级1例。结论:重症心脏瓣膜病术后并发症多,恰当的围手术期处理、合理的手术方式选择是外科治疗重症心脏瓣膜疾病的关键。

Experience of surgical treatment of severe valvular heart diseases in 37 patients

Objective:To summarize the experience of surgical treatment of severe valvular heart disease.Mehtods:The information was retrospectively analyzed in 37 patients with severe valvular heart diseases undergone surgical intervention between Jan.2008 and Jan.2011 in our department,with respect to the preoperative preparation,surgical methods and postoperative management.Results:Of the 37 patients,postoperative low cardiac output occurred in 15,serious arrhythmia in 7,pulmonary infection in 9 and renal failure in 3.There were 3 deaths,in whom 2 were due to low cardiac output and 1,renal failure.Follow-up of 29 patients revealed that recovery of the cardiac functional capacity in Class Ⅰ was 19 cases;Class Ⅱ,6;Class Ⅲ,3 and Class Ⅳ,1.Conclusion:Severe heart valve disease may be complicated a lot after surgery,thus successful management of the disease relies much on appropriate perioperative interventions and favorable surgical approach involvement.