人工生物瓣膜替换手术死因及并发症分析

Causes of Perioperative and Complications of Bioprosthetic Valve Replacement

目的：分析并了解人工生物瓣膜替换手术围术期主要的死亡原因及并发症。方法：收集７４５例人工生物瓣膜替换手术患者的原始临床病历资料，采用回顾性的分析方法进行总结。结果：围术期死亡率为１３．２％（９８／７４５）。围术期主要死因依次为：低心输出量综合征、心力衰竭（４７例），脑部并发症（１４例），严重室性心律失常（９例），肾功能衰竭（８例），人工瓣膜心内膜炎（５例），左心室破裂（３例）．围术期主要并发症依次为：低心输出量综合征、心力衰竭（５８例），二次开胸止血（２５例），脑部并发症（２１例），严重室性心律失常（１３例），肾功能衰竭（１０例），人工瓣膜心内膜炎（１０例），心包填塞（８例）。结论：低心输出量综合征、心力衰竭，脑部并发症，严重室性心律失常，肾功能衰竭和人工瓣膜心内膜炎是围术期人工生物瓣膜替换手术主要的并发症和死因。

Objective:To identify the causes of perioperative death and complications follwing bioprosthetic valve replacement.Methods:Clinical data of 745 cases of bioprosthetic valve replacement were collected and analyzed retrospectively.Results: The perioperative mortality was 13.2% (98/745). The main causes of porioperative deathwere:low cardiac output (47 cases),neurological complications (14 cases),severe ventricular disarrhythmias(9 cases), renal failure (8 cases),bioprosthetic valve endorarditis (5 cases) and rupture of left ventricle (3cases).Main complications of the perioperative peridwere : low cardiac output (58 cases),reoperation for hemorrhage (25 cases),neurological complications (21 cases),severe ventricular disarrbythmias (13 cases),renal failure (10 cases),bioprosthetic valve endocarditis (10 cases) and cardiac tamponade (8 cases).Conclusion: Low cardiac output, neurological complications,severe ventricular disarrhythmias, renal failure and bioprosthetic valve endocarditis are the main complications and causes of death in the perioperative peried following bioprosthetic valve replacement.