重症心脏瓣膜病围手术期治疗体会

The Treatment Experience to Severe Valvular Heart Disease in Perioperative

目的:探讨重症风湿性瓣膜病的手术及围手术期治疗方法。方法:31例患者手术采用含钾机血灌注下行瓣膜置换术,AVR4例,MVR21例,DVR6例。结果:围手术期死亡3例,病死率9.7%。并发症:低心排14例,持续室性心律失常4例,癫痫大发作1例,急性肾功能不全1例。结论:术前正规强心利尿、营养支持治疗和审慎评估,术中良好心肌保护及细致的术后管理对降低重症瓣膜病的手术病死率十分重要。

Objective： To evaluate operation of severe valvular heart disease and treatment in perioperative. Methods： 31 patients were operated for valve replacement, include 4 AVR, 21 MVR and 6 DVR. Results： 3 persons were died in perioperative, the death rate is 9.7%. All complications as follows： low heart output were 14, continuous ventricular rhythm were 4, epilepsia major was 1, epilepsia major was 1. Conclusion： The regular better heart, diuresis, nutrition supportive treatment and careful evaluation were performed before operation. Myocardial preservation in surgery and postoperative administration were also important to patient . It could reduce the mortality.