瓣膜置换术127例临床分析  

The clinical analysis of valve replacement:127 cases report

作　　者：李勇[1] 江汝健[1] 付立[1] 程远建 彭丽娟[1] 

机构地区：[1]四川省攀枝花市中心医院心胸外科,617067

出　　处：《临床合理用药杂志》2010年第2期14-16,共3页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的总结127例瓣膜置换术的临床经验。方法对我院127例在全麻中度低温体外循环下施行瓣膜置换术的病例进行分析。单纯二尖瓣置换术66例,单纯主动脉瓣置换术36例,联合瓣膜置换术25例。二尖瓣置换术用右房-房间隔切口路径59例,用房间沟-左心房切口路径7例;其中保留后瓣27例,三尖瓣成形30例。主动脉瓣置换术36例均采用升主动脉斜行切口,同期行冠状动脉搭桥5例。结果本组术后早期死亡4例,病死率为3.1%;术后发生并发症31例,发生率24.4%。结论科学的术前评估、合理掌握手术适应证、加强围手术期管理、保留瓣下结构、重视三尖瓣返流处理,可提高手术成功率,减少并发症发生率。Objective Summarized the clinical experience of 127 cases of valve replacement. Methods Analysed 127 cases of patients underwent valve replacement anesthesia under moderate hypothcrmic and cardiopulmonary bypass in our hospital. 66 patients with pure mitra] valve replacement,aortic valve replacement alone was 36 cases,combined valve replacement in 25 cases. Mitral valve replacement with the right atrium-atrial sepial incision palb of 59 cases, with the room ditch-the path of left atrial incision in 7 cases,which retained the flap were 27 eases,tricuspid annuloplasty were 30 cases. Aortic valve replacement surgery were used oblique incision in ascending aorta during the same period 5 cases underwent coronary artery bypass grafting. Results 4 patients died after surgery, the mortality was 3.1% ;31 cases developed postoperative complications,the incidence rate was 24.4%. Conclusion Preoperative evaluation of the scientific,rational master the surgical indications,to enhance perioperative management, and preservation of subvalvular attach importance to tricuspid regurgitation, may improve the success rate and reduce complication incidence rate.

关 键 词：瓣膜置换术 三尖瓣成形 瓣下结构 

分 类 号：R654.2[医药卫生—外科学]