体外循环心内直视手术53例临床分析

CLINICAL ANALYSIS OF INTRACARDIAC OPERATIONS OF 53 CASES UNDER DIRECT VISION AND EXTRACORPOREAL CIRCULATION

目的 :总结 5 3例体外循环心内直视手术中的一些经验教训。方法 :本组 5 3例心脏病患者 ,均在低温体外循环下手术 ,房缺修补 11例 ,室缺修补 2 2例 ,法乐氏四联症 1例 ,瓣膜置换 17例 ,心房粘液瘤 2例。 3例合并其它畸形予以同期矫治。结果 :体外循环时间在 4 3～ 15 0min ,主动脉阻断时间 14～ 97min ;术后 30日内死亡率为5 6 % (3/5 3) ,并发症发生率 11 3% (6 /5 3) ,5 0例随访 1月～ 7年恢复较好。结论 :开展心内直视手术应充分做好围术期准备 ,正确处理体循环管理及心肌保护 ,术后监护强调术后监护及并发症的处理。

Objective:To investigate 53 cases of intracardiac operations under direct vision and extracorporeal circulation.Method:Surgical procedures of 53 cases were conducted under conditions of low temperature and extracorporeal circulation. Of which 11 were for repair of auricular septal defect, 22 for repair of ventricular septal defect, 1 Fallot's tetrad, 17 valve replacement and 2 atrial myxoma,and 3 complicated with other deformities.Results:The mean time of extraporporeal circulation was 43～150 minutes with aortic blocking time 14～97 minutes. Postoperative mortality was 5.6%(3/53) and incidence of complications was 11.3% (6/53). 50 cases had recovered well in the 1 month to 7 years follow-up.Conclusion:Firstly, perioperative care is very important for the procedure; Secondly, proper management during the surgical operation including protection of myocardium must be stressed; and finally, postoperative care and management of complications should not be neglected.