重症瓣膜病患者外科治疗经验  

The experience of severe valve disease patients with surgical treatment

作　　者：陈巍[1] 孙文婷[2] 田海[1] 张东旸[1] 傅毕成 蒋树林[1] 

机构地区：[1]哈尔滨医科大学附属第二医院心血管外科,黑龙江哈尔滨150081 [2]海军总医院心脏中心,北京100048

出　　处：《哈尔滨医科大学学报》2016年第3期232-235,共4页Journal of Harbin Medical University

基　　金：黑龙江省杰出青年科学基金(JC2015020);高等学校博士学科点专项科研基金(博导类)(20122307110020)

摘　　要：目的回顾总结重症瓣膜病患者的外科治疗经验。方法收集2008年1月~2012年12月期间于哈尔滨医科大学附属第二医院心血管外科行手术治疗的115例大左室、低射血分数及高龄瓣膜病患者的临床资料,并进行比较分析研究。均采取全麻低体温体外循环下进行手术治疗。结果除16例患者死亡外,其他患者均痊愈出院,其中大左室患者死亡4例,低射血分数患者死亡0例,高龄患者死亡6例,合并两种及以上情况组死亡6例,各组死亡率分别为9.1%、0%、20.7%、22.2%,住院时间分别为（34.4±14.5）天、（33.6±11.2）天、（46.5±16.1）天、（36.3±13.1）天,手术时间分别为（222.39±60.78）min、（228.0±58.46）min、（210.0±53.76）min、（245.56±57.77）min,ICU时间分别为（74.02±57.58）h、（87.73±67.12）h、（162.28±145.97）h、（95.81±85.11）h。结论选择好手术时机,尽可能缩短手术时间及阻断时间,术后加强围术期管理、避免其他并发症发生等,是此类重症瓣膜病患者外科治疗成功的关键。Objective To analyze the experience of severe valve disease patients with surgical treatment. Methods The clinical data of 115 cases with larger left ventricular,low ejection fraction or the elderly valve disease in our hospital from January 2008 to December 2012 were collected and retrospectively studied. All the surgery was taken under anesthesia hypothermia during cardiopulmonary bypass. Results All the patients were cured except 16 cases,including 4 cases with large left ventricular,6 elderly patients,6 cases with large left ventricular and venerable age. The mortality in each group were 9. 1%,0%,20. 7%,22. 2%,respectively. The average hospitalization time were（ 34. 4 ± 14. 5） days,（ 33. 6 ± 11. 2） days,（ 46. 5 ± 16. 1） days,（ 36. 3 ± 13. 1） days,respectively. The average operative time were（ 222. 39 ± 60. 78） minutes,（ 228. 0 ± 58. 46） minutes,（ 210. 0 ± 53. 76） minutes,（ 245. 56± 57. 77） minutes,respectively. The average ICU time were（ 74. 02 ± 57. 58） hours,（ 87. 73± 67. 12） hours,（ 162. 28 ± 145. 97） hours,（ 95. 81 ± 85. 11） hours,respectively. Conclusion The good timing of surgery,skilled,accurate and rapid surgical operation,the short operation time and off-pump time,the less postoperative complications are the key points for successful treatment for the patients with severe valve disease.

关 键 词：重症瓣膜病 大左室 低射血分数 高龄 

分 类 号：R542.5[医药卫生—心血管疾病]