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作 者:张广福[1] 都兴琅[1] 张向华[1] 姜贯华[1] 王镇祥 扬文东 李凡东[1] 梁家立[1]
机构地区:[1]中国人民解放军济南军区总医院心外科
出 处:《中国循环杂志》1994年第9期537-538,共2页Chinese Circulation Journal
摘 要:本院自1984年3月至1992年12月,应用侧倾碟瓣、牛心包生物瓣和St.Jude瓣施行心脏瓣膜替换122例。除1例外,病因均为风湿性病变。二尖瓣替换96例,双瓣膜替换17例,主动脉瓣替换9例。心功能(NYHA)Ⅲ级者78例,Ⅳ级者21例。术后1个月内死亡15例(12.3%)。死亡原因主要为心室颤动,细菌性、霉菌性心内膜炎,低心输出量综合征等。83例随访6~96个月,晚期死亡5例。余均症状改善,多数已恢复工作。本文还就换瓣手术指征,心室颤动的原因,重症患者机械呼吸的应用,术后心内膜炎等问题进行讨论。From March 1984 to December 1992,122 patients had valve replacement of tilting disc prostheses, calf heterograft and St.Jude prostheses in our hospital.All of the patients were of rheumatic heart disease except one. Mitral valve was replaced in 96 cases,double valves in 17 and aortic valve in 9.Preoperative heart function was class III(NYHA) in 78 cases and class IV in 21.15 cases died postoperatively in the first month (mortality 12.3%). The main causes of death were ventricular fibrillation, bacterial and mycotic endocarditis and low cardiac output.83 cases were followed up for 6 to 96 months. There were 5 cases of late death. Symptoms of the survivors were all improved and the majority resumed work. The indications forvalve replacement,causes of ventricular fibrillation, application of mechanical respiration in critical patients, and postoperative endocarditis were discussed.
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