高龄和高危心脏瓣膜置换病人28例的治疗  

Valve replacement in high age and high risk patients

作　　者：黄健宏[1] 梁桂霞[1] 王茂生[1] 吴全忠[1] 

机构地区：[1]茂名市人民医院心胸外科,广东茂名525000

出　　处：《岭南心血管病杂志》2007年第4期267-269,共3页South China Journal of Cardiovascular Diseases

摘　　要：目的总结高龄和高危心脏瓣膜病人行瓣膜置换术的疗效,探讨影响手术疗效因素及手术适应证。方法2000年3月～2005年10月,共行高龄(年龄超过65岁)和高危心脏瓣膜置换术28例:单纯二尖瓣置换17例;主动脉瓣置换3例;二尖瓣及主动脉瓣置换6例;行二尖瓣置换及冠状动脉旁路移植术2例。同期行三尖瓣成形术21例。结果术后早期并发症18例;晚期死亡1例,死因为肺出血。术后2周、3个月复查超声心动图示各心腔内径较术前明显缩小。随防出院者时间3～36个月,术后心功能Ⅰ～Ⅱ级27例,Ⅲ级1例。结论提高高龄和高危心脏病人手术疗效的关键是选择合适手术时机,妥善处理围术期和术后高危因素。Objectives To evaluate the efficiency of valve replacement in high age and high risk patients, the main influencing and the operation indication. Methods The vavular operations were performed in 28 cases from Mar. 2000 to Oct. 2005. Mitral valve replacement was performed in 17 cases, aortic valve replacement in 3, combined mitral and aortic valve replacement in 6, combined mitral valve replacement and coronary bypass grafting in 2, concomitant tricuspid valve annuloplasty in 21. Results Eighteen cases had the early postoperative complication. The late mortality was 3.6% （1/28）. In 2 weeks and 3 months after surgery, echocardiography showed every cardiac ventricle diameter significantly decreased. The heart function was class Ⅰ - Ⅱ in 27, and class Ⅲ in 1. Conclusions The keys to improve the outcome of these operations are to choice optimum surgical timing and the proper management of the high risk factors at the operative period and followup periods.

关 键 词：心脏瓣膜疾病 高龄 高危 心脏瓣膜假体植入 

分 类 号：R542.5[医药卫生—心血管疾病] R318.11[医药卫生—内科学]