瓣膜置换术后严重肝功能不全的临床分析  

Clinical analysis of postoperative hepatic failure in patients undergoing valvular surgery

作　　者：李秋泽[1] 魏松洋[1] 寇卫军[1] 

机构地区：[1]解放军第155中心医院胸心外科,河南省开封475003

出　　处：《中国现代医药杂志》2007年第2期85-87,共3页Modern Medicine Journal of China

摘　　要：目的报告26例瓣膜置换术后肝功能不全的防治经验。方法1996年1月至2006年9月,共治疗26例瓣膜置换术后肝功能不全患者,其中二尖瓣置换4例,主动脉瓣置换9例,二尖瓣及主动脉瓣联合置换13例。术前心功能Ⅱ级2例,Ⅲ级18例,Ⅳ级6例。本组患者均于术后第5～8天出现肝功能不全。结果救治存活15例,9例因严重肝功能不全或继发多脏器功能不全死亡,本组死亡率34.6%。救治存活与否与手术类别无明显关系。结论瓣膜手术后并发肝功能不全的防治重点在于术后处理;肝功能不全与多脏器功能不全互相影响并且加重。Objective To report the experience on treating postoperative hepatic failure （HF） after valve surgery in 26 cases. Methods In 26 patients, MVR had been performed in 4 patients, AVR in 9 and DVR in 13.NYHA functional class Ⅱ was in 2,Ⅲ in 18, and Ⅲ-Ⅳ in 6. HF in 36 patients occurred within 5-8d after operation. Results. Fifteen of the 36 patients survived and 9 died of HF or MODS （multiple organ dysfunction syndrome）. The mortality was 34.6%. Conclusion Postoperative surveillance is more important in HF patients; There is a close relationship between HF and MODS.

关 键 词：瓣膜手术 肝功能不全 防治 

分 类 号：R654.2[医药卫生—外科学]