重症心脏瓣膜病术前营养调整的价值

目的:探讨重症心脏瓣膜病术前营养调整支持治疗的效果.方法:2005年10月～2009年8月共手术治疗207例心脏瓣膜病,其中56例重症心脏瓣膜病,入院时心胸比率0.58～0.98,平均0.68±0.54,>0.7者22例,心功能均为Ⅲ级或Ⅳ级;术前全部给正规营养支持治疗,手术后恢复效果良好.结果:住院死亡1例,死亡率1.8%;术后急性心包填塞1例,低心排6例,急性肾功能不全1例.结论:重症换瓣病人术前的营养支持能显著改善其营养状况,提高重症心脏瓣膜病外科手术成功率,缩短其恢复时间,减少并发症的发生及降低死亡率.

Value of preoperative nutrition in severe heart valve surgery

Objective：To investigate the effect of preoperative nutritional support treatment in severe valvular heart disease so as to reduce surgical risk and improve surgical effectiveness.Methods：To investigate 56 patients who had severe valvular disease and received mechanical heart valve replacement from October 2005 to August 2009.Their cardiothoracic ratios were from 0.58 to 0.98,with an average 0.68±0.54,which of 22 cases was greater than 0.7.Their cardiac functions were at grade Ⅲ or Ⅳ.All of the patients were therapied with formal cardiac nutrition,diuretic,and other treatment to achieve good effect.Results：1 patients died during hospitalization,and the mortality rate was 1.8%.Complications：acute cardiac tamponade in 1 cases,low cardiac output in 6 cases,acute renal insufficiency in 1 case.Conclusion：It is very useful that the patients with severe heart valve disease receive perioperative myocardial nutritional.