83例重症心脏瓣膜病的外科治疗体会

83 cases of severe surgical treatment of valvular heart disease

目的总结重症心脏瓣膜病的手术治疗经验。方法2004年6月至2011年6月我院共对82例重症心脏瓣膜病患者实行了心脏瓣膜置换术。结果术后早期死亡4例，3例死于术后低心输出量综合征，1例于术后一周出现心包填塞，呼吸、循环功能衰竭，抢救无效死亡，余病例全部康复出院。死亡率4．82％。术后随访，复查心脏彩超示心脏均有不同程度缩小，心功能均有改善，其中心功能I级20例，Ⅱ级56例，Ⅲ级4例。结论只要严格掌握手术适应证，积极有效的术前准备，加强心肌保护和提高手术技巧，严密的术后监护，就可以提高重症心脏瓣膜病手术的成功率。

Objective To summarize the surgery experience of severe valvular heart disease. Methods From June 2004 to June 2011 ,a total of 82 patients in our hospital with severe heart valve disease underwent valve replacement surgery. Results Early postoperative,4 died,3 died of low cardiac output syndrome, 1 case died of respiratory, circulatory failure in a week after surgery because of pericardial tamponade. The remaining patients all recovered and were discharged. Mortality rate was 4. 82%. Follow - up of 74 cases all reviewed of echocardiography, 20 cases of showed varying degrees of reduced cardiac, cardiac function were improved, the center features 20 cases of cardiac function grade I , 56 cases in grade H ,4 cases in grade Ⅲ Conclusion It could increase the achievement ratio in the operations with severe valvular heart disease by Strict indications, effective preoperative preparation and myocardial protection, skilled surgical techniques and close monitoring.