心血管白塞病的外科治疗

Surgical treatment for cardiovascular Behcet's disease

目的:总结心血管白塞病的外科治疗经验及教训,探讨改进心血管白塞病的外科治疗的方法。方法:2004年10月至2010年11月,我院心血管外科共收治了主动脉瓣关闭不全心血管白塞病的患者10例,有4例进行了1次手术,6例进行了2次手术。结果:10例患者第1次行主动脉瓣置换术后,1例患者因为多器官功能衰竭死亡,9例出院继续药物治疗。第1次手术治疗出院后的9例患者中,有6例出现了术后瓣周漏,其中1例经过第2次行心脏原位移植,术后因为多器官功能衰竭死亡;另5例经过第2次主动脉瓣置换手术,其中4例术后,再出现瓣周漏,最终因为严重低心排出量综合征而死亡;本组共4例长期存活。结论:外科治疗心血管白塞病,易并发瓣周漏,病死率高,故手术治疗应慎重,正确选择手术时机和手术方式,有助于减少术后并发症的发生。

Objective To analyze the surgical treatment for cardiovascular Behcet＇s disease, and to develop the operating techniques. Method Between Oct. 2004 and Nov. 2011, 10 patients with Behcet＇s disease and aortic valve regurgitation received operations in the cardiovascular division of the Gangdong General Hospital, 4 of them were operated once, while the other 6 patients were operated twice. Results One patient died from multiple organ dysfunction syndrome （MODS） and the other 9 patients received pharmacological treatment after surgery. Six of the 9 patients suffered from paravalvular leak, 1 of them died from MODS after heart transplantation, and the other 5 patients received aortic valve replacement. After the second time of surgery, 4 of the 5 patients suffered from paravalvular leak, and died from severe low cardiac output volume. Only 4 patients survived. Conclusion Atients with Behcet＇s disease, who received surgical treatment was susceptible to paravalvular leak and was in a high mortality. Therefore, the determination of surgical treatment should be under full consideration, the appropriate operation and intervention point were essential to reduce the complications.