二尖瓣置换术后左室破裂的外科处理  

The risk factors and treatment of left ventricular rupture after mitral valve replacement

作　　者：周新明[1] 李伦明[1] 梁湘源[1] 张志刚[1] 王广阔[1] 邓毅权[1] 孙洁群[1] 

机构地区：[1]江门市中心医院心血管外科,529030

出　　处：《国际医药卫生导报》2011年第12期1421-1423,共3页International Medicine and Health Guidance News

摘　　要：目的 分析二尖瓣置换术后发生左心室破裂的高危因素、原因、转归，总结治疗经验。方法回顾性分析江门市中心医院2000年1月-2010年12月期间856例接受二尖瓣置换及二尖瓣、主动脉瓣联合置换手术患者的临床资料，共有3例（0．35％）发生术后左心室破裂，其中早期破裂2例、延迟性破裂1例。早期破裂2例均在体外循环心脏停跳下进行修补，1例采用单纯心外缝合修补，1例采用单纯心内修补方法。1例延迟性破裂在监护室紧急开胸探查证实诊断后，在床边采用非体外循环下心外缝合修补。结果2例死亡，1例存活，存活者为早期破裂患者采用心内修补患者。结论对于左心室破裂的防治目前仍以预防为主。对早期破裂患者可综合应用多种方法提高治疗成功率延迟破裂者生存率极低，是目前治疗上面临的主要难题尽早控制出血并恢复重要器官的血流灌注是改善预后的关键。Objective To analyze the risk factors and treatment experience of left ventricular rupture after mitral valve replacement. Methods Retrospective analysis of 856 patients with mitral valve replacement, a total of 3 cases （0.35%） postoperative rupture of left ventrieular. 2 eases occurred early after surgery, the other case occurred in 4 days after surgery.one patient were sutured in the heart, 2 patients were sutured outside the heart.Results 2 patients died, 1 patient survival, the survival patient were repaired rupture in the heart early. Conclusion Left ventricular rupture after mitral valve replacement with high mortality, prevention of preoperative and intraoperative is the most important, take the right treatment can improve survival rate.

关 键 词：二尖瓣替换术 心脏破裂 风湿性心脏病 

分 类 号：R654.2[医药卫生—外科学]