二尖瓣主动脉瓣联合病变的瓣膜置换手术治疗  

Replacement Treatment of Mitral Combined with Aortic Valve on Patients with Valavular Diseases

作　　者：郭德和[1] 陆相扬[1] 韩育宁[1] 李晋南[1] 

机构地区：[1]宁夏医学院附属医院胸心外科,银川750004

出　　处：《宁夏医学院学报》2007年第5期474-476,共3页Journal of Ningxia Medical College

摘　　要：目的总结二尖瓣主动脉瓣联合病变的瓣膜置换手术治疗经验。方法回顾分析1989年8月至2006年12月收治的72例二尖瓣主动脉瓣联合病变行双瓣置换手术（DVR）患者的临床资料。全组男39例,女33例。年龄16~61岁,平均46.3岁。术前心功能（NYHA）Ⅲ级36例,Ⅳ级19例。结果全组行双瓣置换手术（DVR）病人风湿性瓣膜病64例,感染性心内膜炎（IE）8例。其中保留瓣膜及瓣下结构37例（占51.4%）,同期行三尖瓣成形（TVP）32例（占44.4%）。术后早期并发症12例（占16.7%）,死亡4例（占5.5%）。随访2个月~5年,远期死亡1例。结论选择适当的手术时机、充分的术前准备、良好的手术技巧和围术期处理是获得良好手术效果的重要因素。Objective To summarize the experience of replacement treatment of mitral combined with aortic valve on patients with valavular diseases.Methods 72 patients with mitral and aortic valve diseases were performed double valve replacement from Aug 1989 to Dec 2006.There were 39 males and 33 females and the mean age was 46.3 year-old（range,16～61 year-old）.The preoperative NYHA heart functional was class Ⅲ in 36 cases and classⅣ in 19 cases.Results The patients received double valve replacement,were rheumatic valvular disease in 64 cases,and infectice endocarditise in 8 cases.37 cases were performed the mitral valve replacement with subvalvular structure preservation and 32 cases were performed the tricuspid valve annuloplasty.12 cases were found postoperation early complication（16.75%）,and 4 cases died（5.6%）.All patients were fellowedup from 2 months to 5 years.There was 1 cases late deaths.Conclusion The better results would be achieved with proper indication,full preoperative preparation,selection of surgical techniques,proper perioperative management and anti-coagulation treatment after the operation.

关 键 词：心脏瓣膜病 心脏瓣膜假体植入 二尖瓣 主动脉瓣 

分 类 号：R654.2[医药卫生—外科学]