心脏停跳和不停跳下瓣膜置换术后观察与处理的对比分析  

To compare the Clinical Effects of Valvular Replacement with Beating Heart and Blood Cardioplegic Arrest

作　　者：刘晓莉[1] 朱学敏[1] 杜俊兰[1] 

机构地区：[1]第三军医大学新桥医院心外科,400037

出　　处：《重庆医学》2000年第3期212-213,共2页Chongqing medicine

摘　　要：目的　对比分析心脏停跳和不停跳心内直视下行瓣膜替换术的疗效。方法　２３８例患者分别采用心脏停跳组和不停跳组两种手术方法。其中心脏停跳手术８８例，包括ＭＷＲ６０例，ＡＶＲ２例，ＤＶＲ２６例；不停跳手术１５０例，包括ＭＶＲ１０１例，ＡＶＲ１７例， ＤＶＲ３２例。不停跳组降温至 ３２± １℃并维持，仅阻断上下腔静脉，不阻断主动脉，余同停跳下手术。结果　不停跳组早期死亡２例（死亡率 １． ３３％），停跳组早期死亡 ４例（死亡率 ４． ５４％），其余均痊愈出院，随访 ３月～ ４年，恢复良好。结论　心脏不停跳心内直视手术，是一种有效的心肌保护方法，能减少并发症，缩短住院时间。Objective:To compare the effects of valve replacement on beating heart and blood cardioplegic arrest.Methods:88 cases were ac- cept operation on arrest, and 150 cases were accept operation on beating heart. In beating heart group,only clamp the two venae cavae with keep- ing the perfusion of cannulation of aorta at 32± 1℃ of the body temperature.The methds of valve replacement were same the aorta cross- clamping in blood cardioplegic arrest group. Results:There were two patients surgical death (1. 33 % ) in beating heart group and four patients surgical death (4.54% ) in arrest group. The others were cured and followed - up for 3 -48months. The recovery were good.Conclusion:The open-heart op- eration on beating heart is a new good way for myocardial protection. It can reduce the complication and shorten the mean of hospital time than ar-rest group.

关 键 词：心脏不停跳 心脏瓣膜置换术 心脏停跳 对比分析 

分 类 号：R654.2[医药卫生—外科学]