老年心血管疾病的外科治疗  

Surgical treatment in aged patients with cardiovascular disease

作　　者：申翼[1] 景华[1] 李德闽[1] 李忠东[1] 胡小南[1] 董国华[1] 钱建军[1] 许飚[1] 

机构地区：[1]南京军区南京总医院心胸外科,江苏南京210002

出　　处：《医学研究生学报》2006年第10期904-906,909,共4页Journal of Medical Postgraduates

基　　金：江苏省自然科学基金青年科技创新人才项目(批准号:BK2005431)

摘　　要：目的:总结老年心血管疾病的外科治疗特点。方法:回顾分析1994年1月至2004年9月间,在我科手术的60岁以上老年心血管疾病患者138例,对其病变特征、手术方式、体外循环管理及围手术期处理进行讨论。结果:术后出现并发症23例(16.7%),死亡7例(5.1%),其中3例死于严重术后低心排血量,4例术后死于多器官功能衰竭综合征。随访109例(78.9%),术后心功能和生活质量明显改善。结论:高龄是心血管外科治疗的高危因素之一,但并非手术禁忌,严格掌握手术适应证、选择适当手术方式、加强术中心肌保护和围手术期处理是提高手术治疗效果的关键。Objective：The purpose of this study was to review the clinical experiences of surgical treatments in the elderly with cardiovascular disease. Methods：A retrospective study was carried out at our hospital from Jan. 1994 to Sep. 2004. A total of 138 patients with cardiovascular diseases submitted to surgical treatment were included. The clinical characters, surgical techniques, cardiopulmonary bypass managements, main complications, and therapeutic principles were reviewed. Results：Postoperative complications occurred in 23 （ 16.7% ） patients, 131 patients （94.9%） were successfully treated and their cardiac functions were improved significantly, especially in the patients with preoperative NYHA Ⅳ. Only 7 patients （5.1% ） died, 3 from severe postoperative low output syndrome, another 4 from multiple organ failure. Conclusion：Advanced age is an independent risk factors but not a contraindication for the operative process in nowadays surgical activities. We believe that choosing the appropriate operative modalities, and paying good attentions to the management of perioperative cardiac function and postoperative complications, can help to improve results.

关 键 词：老年 心血管疾病 围手术期处理 

分 类 号：R654.2[医药卫生—外科学]