重症心脏瓣膜病的围术期处理  

Perioperative management of severe cardiac valve diseases

作　　者：张万青[1] 苏廷宝[1] 程可洛[1] 张光休[1] 何悦概[1] 陈捷[1] 黄一东[1] 

机构地区：[1]广东医学院附属医院胸心外科,广东湛江524001

出　　处：《中国基层医药》2005年第8期1032-1034,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的总结重症心脏瓣膜病患者围术期处理经验,提高患者的治愈率。方法回顾性研究1999年9月至2004年10月外科治疗78例重症心脏瓣膜病患者的围术期处理、心肌保护方法、手术方式。结果低心排综合征5例,活动性出血二次开胸止血3例,脑栓塞2例,迟发性心脏破裂1例,肾功能不全1例,肺部感染1例,死亡3例。结论加强围术期处理,加强术中心肌保护,彻底纠正瓣膜畸形及注意人工瓣膜的选择,重症心脏瓣膜病亦可取得良好的早期效果。Objective In order to improve the cure rate of surgery treatment of severe cardiac valve diseases. Methods 78 cases of severe cardiac valve diseases had receiveed the cardiac vavle replacement from September 1999 to October 2004 were studied retrospectively. Perioperative management and myocardial protection were emphasized. Surgery methods also were reviewed. Results Low-heart output sydrome in 5, re-operation for mediastinal hemorrage in 3, cerebral infarction in 2, delayed-heart corruption in 1, renal insufficiency in 1, pulmoanary infecion in 1, death in 3. Conclusion Perioperative management and myocardial protection were emphasized. Complete correction of cardiac valve abnormality and the selection of artificial heart valve are important, the patients with severe valve diseases can recoverly well at early-staged period.

关 键 词：心脏瓣膜疾病 围手术期医护 心脏瓣膜假体植入 重症心脏瓣膜病 围术期处理 迟发性心脏破裂 低心排综合征 二次开胸止血 心肌保护 活动性出血 

分 类 号：R654.2[医药卫生—外科学] R571.3[医药卫生—临床医学]