体外循环心脏直视术后胃肠道并发症4例原因及对策分析

目的总结我院4例患者于体外循环术后发生严重胃肠道并发症的原因及治疗。方法本院在完成500余例心脏直视手术中,有4例发生严重胃肠道并发症,发生率为0.71%。2例为冠状动脉搭桥术,1例为冠状动脉搭桥并二尖瓣置换术,1例为二尖瓣置换术,年龄47～60岁,手术后2～14d出现腹痛、腹胀和呕吐咖啡样物及排柏油样黑便。本组1例行内科治疗,3例行急诊手术。结果本组治愈3例,死亡1例,死亡率为0.24%。结论原有溃疡病史、术前心功能差、原发病严重、术后低心输出量综合征等可能是导致胃肠道并发症的原因。及时、正确的诊断及治疗非常重要。

Objective To sum up the causes and therapies of gastrointestinal complications in 4 patients who underwent cardiopulmonary bypass surgery. Methods There were 4 patients who combined serious gastrointestinal complications after cardiopulmonary bypass surgeries in more than 1500 cases. The incidence was 0.27%. These operations were CABG or/and AVR. The age was 47-60 years old. Symptoms such as abdominal pain and distension ,vomit were appeared 2-14 days later after operation.One case was managed by drugs, the others operated urgently. Results Three cases cured,1 case died,the mortality rate was 0.24%. Conclusion The history of ulcer, bad function of heart, and low output syndrome all can lead to gastrointestinal complications. Prompt and correct diagnosis and therapy are very important.