心瓣膜置换术80例临床分析

Clinical Analysis on 80 Cases of Cardiac Valve Replacement

目的：总结心瓣膜置换术手术方法、围术期处理经验，以提高手术成功率并减少术后并发症。方法：回顾性分析我院2000年2月～2008年11月总计80例心瓣膜置换术的手术技术、心肌保护、术后处理以及死亡原因等。80例中单纯行二尖瓣置换术（MVR）50例，主动脉瓣置换术（AVR）12例，双瓣联合置换术（DVR）18例（1例为再次双瓣置换术）；同期行三尖瓣Devega成形术48例。结果：本组76例痊愈，4例死亡，死亡率5％。术后二次开胸止血6例，占7．5％（6／80），无其他严重并发症。结论：提高手术技巧、改进心肌保护方法、加强围术期管理等，可显著降低心瓣膜置换术的死亡率和并发症发生率。

Objective：To summarize the operative methods of cardiac valve replacement and the perioperatively handling experience, in order to improve operative procedures and decrease postoperative complications. Methods： To analyze the operative procedures, myocardial preservation, postoperative treatments and causes of death in 80 patients who were hospitalized in our department from Feb. 2002 to Nov. 2008 and underwent cardiac valve replacement. Among these cases, 50 patients accepted a simple replacement of mitral valve, 12 received aortic valve replacement, and 18 underwent double valve replacement, 48 were performed the De-Vega tricuspid valvuloplasty simultaneously. Results：Four patients dead, the death rate was 5%. Six patients （7.5%） had to accept the second tnoracotomy to stop bleeding. No other severe complications were observed. Conclusions ： The death rate of cardiac valve replacement and the incidence of postoperative complications could be significantly reduced by improving the surgical techniques, enhancing the myocardial preservation, emphasizing the perioperative managements, etc.