摘要
总结1981年10月至1994年12月60例生物瓣膜失功能病人再次行瓣膜替换术的经验。病人年龄16~62岁(平均36.1±7.3岁)。两次换瓣间隔时间为26~168个月(平均102.9±24.6个月)。手术死亡7例,手术死亡率11.7%。前期(1981年10月至1985年12月)死亡率57.1%(4/7);后期(1986年1月至1994年12月)死亡率5.7%(3/53)(P=0.0001)。结论:对生物瓣失功能病人应及早行再换瓣术、术前应积极改善心功能、术中勿过多游离心包粘连、注意心肌保护、术后重症低心排者积极采用主动脉内球囊反搏术等。上述措施可有效降低手术死亡率。
Sixty patients, aged 16~62 yearold with an average of 36±7.3 years,with bioprostheses dysfunction underwent reoperations from Oct, 1981-Dec,1994.The interval between two operations was 26~168 months (average 102.9±24.6 months).Overall mortality was 11.7%(7/60)In early years(Oct, 1981-Dec,1985),the mortality was 57.1%(4.7),and decreased to 5.7%(3/53)lates(Jan, 1986-Dec,1994) (P=0.0001).Conclusions:(1)Once significant valve dysfunction is noted reoperation should be undertaken;(2)Heart function should be improted maximally before operation;(3)Myocardial pro-tection during operation is of paramount importance; (4) Excessive dissection of pericardial adhesions should be avoided;(5) Intra-aortic balloon pumping for couuter pulsation should be contidesed as soon as severe low cardiac output appears.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
1996年第6期327-329,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
关键词
心脏瓣膜置换术
再手术
死亡率
Bioprosthetic valve dysfunction Reoperation for prosthetic valve replacement