风湿性心脏病合并心脏恶液质综合征的外科治疗  

THE SURGICAL TREATMENT OF RHEUMATIC HEART DISEASE WITH SYNDROME OF CARDIAC CACHEXIA

作　　者：张开广[1] 缪丙荣[1] 胡正群 俞晖 王尉 

机构地区：[1]东南大学医学院附属徐州医院,徐州市第四人民医院胸心外科,江苏徐州221009

出　　处：《中国医师进修杂志》2003年第18期16-17,共2页Chinese Journal of Postgraduates of Medicine

摘　　要：目的　探讨风湿性心脏病合并心脏恶液质综合征的外科治疗方法和特点。方法　对 1996年 4月至 2 0 0 2年12月符合心脏恶液质综合征诊断标准的 18例风湿性心脏病患者外科治疗的临床资料进行回顾性分析 ,其中二尖瓣置换术 14例 ,二尖瓣及主动脉瓣置换术 4例 ,18例均同时进行 De Vega三尖瓣成形术。结果　术后主要并发症为低心排综合征及在此基础上并发的多脏器功能衰竭 ,早期死亡 4例 ,均为多脏器功能衰竭。结论　外科治疗可提高风湿性心脏病合并心脏恶液质综合征病人的治疗成功率和长期存活率 ,正确恰当的围术期处理是手术成功的关键。Objective\ To study the surgical therapeutic method and features for rheumatic heart disease with syndrome of cardiac cachexia. Methods\ 18 cases of rheumatic heart disease with syndrome of cardiac cachexia were reviewed from April 1996 to December 2002 and the clinical data of surgical treatment were analysed. 14 cases were treated with replacement of mitral valve and 4 with mitral and aortic valve replacement. All of the 18 cases were performed modified DeVega tricuspid valve annuloplasty. Results\ The major postoperative complications were low cardiac output syndrome and multiple organ function failure secondary to the cardiac output syndrome. 4 cases died after operation with multiple organ function failure. Conclusion\ The rates of successful treatment and long-term survive can be increased with surgical treatment for the patients suffered from rheumatic heart disease with syndrome of cardiac cachexia. The key point for successful surgical treatment is depended on accurate peroperative management.

关 键 词：心脏恶液质综合征 风湿性心脏病 外科治疗 

分 类 号：R654.2[医药卫生—外科学]