风心瓣膜病合并心脏恶液质的手术治疗  

Surgical Treatment of Rheumatic Heart Disease with Cardiac Cachexia

作　　者：杨彬[1] 刘峰[1] 龙建平[2] 熊卫民[2] 黄标通[2] 

机构地区：[1]中南大学湘雅二医院胸心外科,湖南长沙410011 [2]解放军第163医院胸心外科,湖南长沙410003

出　　处：《医学临床研究》2010年第12期2259-2260,2263,共3页Journal of Clinical Research

摘　　要：【目的】探讨风湿性心脏病合并心脏恶液质病人的瓣膜置换术的治疗经验。【方法】回顾性分析近10年17例风心瓣膜病伴心脏恶液质病人手术治疗资料。【结果】本组14例（82．4％）存活病人术后心功能及全身状况明显改善，随访6个月至2年，均恢复良好。术后早期死亡2例（11．8％），8例出现术后并发症（47．1％），1例术后反复右心功能不全。【结论】充分的术前准备、正确选择手术时机、术中加强心肌保护和体外循环管理，加强术中处理，术后加强心肺支持、积极处理术后并发症及围手术期的营养支持是提高手术疗效的关键。[Objective] To explore the experience of valve replacement on the patients with rheumatic heart disease complicated cardiac cachexia. [Methods] The surgical data of 17 patients with rheumatic heart disease complicated cardiac cachexia in the recent 10 years were analyzed retrospectively. [Results] Early postopera tive death occurred in 2 cases（11. 8%）. Postoperative complications occurred in 8 cases（47. 1%）. Repeated right heart insufficiency after operation was found in 1 case. The remaining 14 survival patients had obvious improvement of heart function and the symptoms of the whole body, and recovered well after follow up for 6 month to 2 years. [Conclusion]The adequate preoperative preparation, correct choice of the time of the proce dure, the enhancement of myocardial protection and extracorporeal circulation management during the operation, the management of postoperative complications and perioperative nutritional support are the critical for improving the surgical results.

关 键 词：心脏瓣膜疾病/并发症 恶病质/外科学 

分 类 号：R654.2[医药卫生—外科学]