儿童心脏瓣膜置换术早期及中长期效果分析  

The short and long-term results of valve replacement in children

作　　者：甘辉立[1] 张健群[1] 周其文[1] 陈辉[1] 孔睛宇[1] 郑斯宏[1] 穆军升[1] 

机构地区：[1]首都医科大学附属北京安贞医院心外科,100029

出　　处：《中华小儿外科杂志》2007年第7期374-377,共4页Chinese Journal of Pediatric Surgery

摘　　要：目的评价儿童瓣膜置换术同术期及中长期疗效,探讨儿童瓣膜置换术适应证,分析术后抗凝特点及避免或减缓再次手术的方法。方法回顾性分析1991年12月至2006年8月,113例患儿128枚瓣膜置换术围术期疗效及中长期随访结果。结果住院死亡5例(4.4%),其中3例死于低心排综合征,1例死于心律失常,1例死于多器官衰竭。晚期死亡7例(6.5%),其中3例死于抗凝相关并发症。23例生物瓣膜置换患儿中有4例患儿需要行再次手术换瓣,随访的75例机械瓣置换患儿中有8例出现抗凝相关并发症。结论在严格掌握手术适应证的基础上,儿童人工心脏瓣膜置换术有较好的早期及中长期效果,但应尽量置入较大型号的瓣膜并选用相应的手术技巧,以保障儿童的成长,以避免或延缓再次手术,抗凝并发症是儿童瓣膜置换术后应该重视的问题。Objective To evaluate the short and long-term clinical results of the valve replacement in children. Methods The clinical data of 128 valve replacements in 113 children from December 1991 to August 2006 in An Zhen Hospital were retrospectively analyzed. And the short and longterm results were recorded. Results Five cases died during they stayed in the hospital, the early death rate was 4. 4%. Of them, 3 died from low output syndrome, 1 from arrhythmia, and the other 1 from multiple organ dysfunction. There were 7 late deaths, 3 died from the complication of anticoagulant. There 4 cases need the second operation for valve replacement. Conclusions Valve replacement in children can get relative good short and long term results, but modified technique may be needed to avoid redo-operation and anticoagulation complications.

关 键 词：心脏瓣膜疾病 心脏瓣膜 人工 儿童 

分 类 号：R726.5[医药卫生—儿科]