65岁以上老年患者心脏瓣膜病手术治疗的临床分析  

Clinical analysis of surgical treatment of valvular heart disease in elderly patients over 65 years old

作　　者：李彬[1] 陈海生 叶东挺 张春曦[1] 张雄 吴丽映 崔亚玲 朱大量 LI Bin;CHEN Hai-sheng;YE Dong-ting;ZHANG Chun-xi;ZHANG Xiong;WU Li-ying;CUI Ya-ling;ZHU Da-liang(Cardiovascular Surgery, Guangzhou First People’s Hospital, Guangzhou 510000, China)

机构地区：[1]广州市第一人民医院心脏大血管外科,广东省广州市510000

出　　处：《中国心血管病研究》2019年第9期837-840,共4页Chinese Journal of Cardiovascular Research

摘　　要：目的 探讨65岁以上老年心脏瓣膜病患者临床手术治疗的方式及经验.方法 总结2017年3月至2018年11月89例65岁以上的行瓣膜手术治疗的患者,85例患者在全麻、低温、体外循环下正中切口行手术治疗,3例单纯主动脉病变患者通过胸骨上正中小切口手术治疗,1例患者在DSA下行TAVI术.结果 全组体外循环时间(134.48±43.08) min,阻断时间(817.9±34.70)min,术后呼吸机辅助时间(17.26±7.28)min,术后监护时间(54.12±19.96)min,术后住院(10.2±4.8)d.围手术期死亡1例(1.1%).结论 加强手术技术及脏器保护,能减少高龄患者术后的并发症及促进恢复.微创技术等新的技术能更好地处理高龄瓣膜病患者的病变,减少并发症及病死率.Objective To investigate the effect of clinical surgical treatment of valvular heart disease in elderly patients over 65 years old. Methods We summarized 89 patients over 65 years old who underwent valve surgery 2017.3-2018.11;85 patients underwent median incision surgery under general anesthesia, hypothermia and cardiopulmonary bypass;and 3 patients with pure aortic lesions underwent median and small incisions on the sternum. One patient underwent TAVI under DSA . Results Cardiopulmonary bypass time was (134.48 ±43.08) min;blocking time was (817.9± 34.70) min;ventilator-assisted time was (17.26± 7.28) min;post-operative monitoring time was (54.12 ± 19.96) min and post-operative hospitalization was (10.2 ±4.8) days. Perioperative mortality was 1 case (1.1%). Conclusion The complications can be reduced and the recovery can be promoted by strengthening surgical techniques and organ protection. New technology can better deal with elderly patients with valvular disease lesions and reduce complications and mortality.

关 键 词：高龄 瓣膜病 经导管主动脉瓣置换术 小切口 

分 类 号：R654.2[医药卫生—外科学]