78例老年心血管疾病的外科治疗体会

Surgical Treatment of Cardiovascular Disease in 78 Aged Patients

目的总结老年心血管疾病的外科治疗特点。方法回顾性分析心胸外科2001年1月-2011年5月期间60岁以上的老年心脏手术病人的临床资料。结果本组老年心脏病患者78例,男性52例,女性26例;年龄60～82岁;体重41～76 kg。均在体外循环下行心脏手术,平均转流时间为(157.11±53.66)m in,平均阻断时间(94.81±35.79)m in,术后呼吸机辅助时间(22.60±10.44)h。术后早期死亡6例,手术早期死亡率7.69%。术后发生严重并发症11例(14.1%),其中因术后引流量多而行二次开胸探查止血2例(2.56%),低心排3例(3.85%),呼吸功能不全2例(2.56%),术后肾功能不全2例(2.56%),多脏器功能不全2例(2.56%)。结论年龄并非心脏直视手术的禁忌症,选择适当的手术方式、加强围手术期处理是手术治疗成功的关键。

Objective To summarize our experiences of surgical treatment for cardiovascular disease in old patients above 60 years.Methods The clinical data of 78 aged patients undergoing cardiac surgery from Jan.2001 to May 2011 were analyzed retrospectively.Results In all 78 patients,there were 52 males and 26 females,the age was 60 to 82 years old,the weight was 41 to 76 kg.Mean cardiopulmonary bypass time was（157.11±53.66）min,and mean aorta clamping time was（94.81±35.79） min,the time using breathing apparatus was 22.60±10.44 h.There were 6 early death,the mortality was 7.69（6 of 78）.11 cases（14.1%） were with severe complications.2 suffered from massive bleeding,which need reoperation;3 cases were with low cardiac output syndrome,2 with pulmonary functional disorder,2 with renal failure,and 2 with multiple organ dysfunction.Conclusion The age of patients is not a contraindication for the cardiopulmonary bypass cardiac surgery in the elderly,the appropriate operative pattern and perioperative treatment are the keys for a successful operation.