心血管手术150例临床分析

To Analyse the Clinical Data of the Surgical Treatment of 150 Cardiovascular Disease

目的:回顾性分析150例各类心血管手术临床资料,总结其经验教训,以期提高此类疾病的治疗效果。方法:122例先天性心脏病中,8例动脉导管未闻(PDA)行左进胸PDA结扎术,其余114例均在体外循环下行纠治术;20例心脏瓣膜病,行二尖瓣或主动脉瓣单瓣置换术17例,二尖瓣、主动脉瓣联合瓣膜置换术3例;8例冠心病采用非体外循环心脏不停跳冠状动脉旁路移植术(OPCAB),桥血管取左乳内动脉及大隐静脉,搭桥支数2～4支。结果:先天性心脏病组死亡3例,心脏瓣膜病组死亡1例,其余均治愈出院。结论:对一般先天性心脏病,手术安全、效果好;对法乐氏四联症等复杂先天性心脏病,应严格掌握手术指征。瓣膜病人术前应常规药物对症治疗,以改善心功能,选择最佳手术时机,效果显著。对冠心病人采用OPCAB,手术创伤小,心功能恢复快,但应掌握适应症。

Objective:The purpose of this study is to analyze retrospectively the clinical data of the surgical treatment of 150 cardiovaseular diseases so that we can improve operative effects on these typical diseases.Methods: Among 122 patients with congenital heart disease(CHD) ,8 patients were given ligation of patent arterial duct(PDA) and 114 patients underwent the correction of cardiac defects under cardiopulmonary bypass(CPB). Among the heart valve disease, 17 patient underwent aortic valves or mitral valves replacement and 3 patients underwent associated valves replacement. 8 patients with 2 - 4 coronary artery stenosis underwent off- pump coronary artery bypass(OPCAB). Left internal mammary artery and great sephenous vein were used as bypass grafts. Results: 3 patients with Tetralogy of Fallot(TOF) and 1 with valve disease died. Other patients had a good recovery. Conclusion: Surgical treatment is safe in conventional congenital heart diseases. Complicated congenital heart disease should have a strict surgical choice. Heart valve diseases with poor heart function should be treated with medicine before operation. OPCAB is safe, practical and satisfactory in coronary artery stenosis.