风心病患者心脏瓣膜置换术后再入院原因分析

Study on the Causes of Readmission in Patients with Rheumatic Heart Disease after Valve Replacement

目的：探讨我院风湿性心脏瓣膜病患者瓣膜置换术后再入院原因。方法连续收集我院2013年5月～2014年7月再入院的风湿性心脏病瓣膜置换术后的患者，对其入院原因进行分析。结果纳入再入院患者27例，入院原因包括心功能不全12例，出血及栓塞7例，电解质紊乱2例，肺部感染2例，心律失常2例，感染性心内膜炎合并瓣周漏1例，急性胃肠炎1例。1例患者再次手术，25例患者经治疗后出院，死亡2例。结论风心病心脏瓣膜置换术后应重视患者的出院指导，特别是抗凝治疗指导，根据心功能状况合理使用利尿、强心药物，注意休息，加强后续治疗，标准使用抗凝药物，监测凝血，按时随访。

Objective To investigate the causes of readmission for the patient with rheumatic heart disease after valve replacement.Methods 27 patients were collected in our hospital from May 2013 to July 2014 who accepted heart valve replacement, the causes of readmission were analyzed. Results12 of them with heart dysfunction, hemorrhage or thrombosis （7 cases）,electrolyte disorder （2 cases）, pneumonia（2 cases）, arrhythmia（2 cases）, infective endocarditis and perivalvular leakage （1 case）, acute gastroenteritis（1 case）.Conclusion We should pay special attention to the guidance for patients discharge after valve replacement and follow up the usage of anticoagulants and diuretic drugs rationally.