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重症心脏瓣膜病围手术期治疗的临床分析
引用本文:张现普,杨康,廖克龙,张伟,刘鸿翔,张世新. 重症心脏瓣膜病围手术期治疗的临床分析[J]. 重庆医学, 2011, 40(12): 1177-1178,1180. DOI: 10.3969/j.issn.1671-8348.2011.12.013
作者姓名:张现普  杨康  廖克龙  张伟  刘鸿翔  张世新
作者单位:第三军医大学西南医院胸心外科,重庆,400038
摘    要:目的探讨重症心脏瓣膜病围手术期治疗方法。方法回顾性分析2007年7月至2010年7月在本科实施瓣膜置换术的206例重症心脏瓣膜病患者的术前准备,术中、术后处理。其中单纯二尖瓣置换19例,二尖瓣置换加三尖瓣成形77例,二尖瓣置换加三尖瓣成形加迷宫手术24例,单纯主动脉瓣置换9例,主动脉瓣置换加升主动脉置换2例,二尖瓣加主动脉瓣置换加三尖瓣成形58例,二尖瓣加主动脉瓣置换加三尖瓣成形加迷宫手术10例,二尖瓣置换加冠状动脉旁路移植术2例,三尖瓣置换2例,再次手术置换二尖瓣3例。结果死亡7例(低心排致多器官功能衰竭5例,左心室破裂2例)死亡率3.39%。电话、门诊随访185例,随访时间4~40个月,心功能(NYHA)Ⅰ级47例、Ⅱ级128例、Ⅲ级10例。结论对重症心脏瓣膜病患者,术前调整心功能,选择合适的手术时机,术中注意心肌保护,注意保留瓣下组织,术后使用必要的辅助手段,可提高手术成功率。

关 键 词:心脏瓣膜疾病  手术期间  瓣膜置换

The clinical analysis of the peroperative period in severe valvular heart disease
Zhang Xianpu,Yang Kang,Liao Kelong,Zhang Wei,Liu Hongxiang,Zhang Shixin. The clinical analysis of the peroperative period in severe valvular heart disease[J]. Chongqing Medical Journal, 2011, 40(12): 1177-1178,1180. DOI: 10.3969/j.issn.1671-8348.2011.12.013
Authors:Zhang Xianpu  Yang Kang  Liao Kelong  Zhang Wei  Liu Hongxiang  Zhang Shixin
Affiliation:Zhang Xianpu,Yang Kang,Liao Kelong,Zhang Wei,Liu Hongxiang,Zhang Shixin(Department of Cardio-thoracic Surgery,Southwest Hospital,Third Military Medical University,Chongqing 400038,China)
Abstract:Objective To investigate the therapeutic method of the Peroperative Period in severe valvular heart disease.Methods To summarize the treatment of 206 inpatients,from July 2007 to July 2010,with severe valvular heart disease during the preoperotive,intraoperative and postoperative by retrospective analyze.Nineteen patients took mitral valve replacements.Seventy-seven patients took mitral valve replacements and tricuspid valve repairs.Twenty-four patients took mitral valve replacements,tricuspid valve repairs...
Keywords:heart valve diseases  intraoperative period  valve replacement  
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