心血管康复医学杂志
心血管康複醫學雜誌
심혈관강복의학잡지
JOURNAL OF CARDIOVASCULAR REHABILITATION MEDICINE
2001年
1期
20-22
,共3页
心脏瓣膜置换术%死亡原因
心髒瓣膜置換術%死亡原因
심장판막치환술%사망원인
目的:分析患者心脏瓣膜转换术后住院期死亡的原因和相关因素。方法:全组均在全麻低温体外循环(CPB)下行瓣膜置换术。结果:患者总死亡率9.9%,死亡原因:(1)低心输出量综合征是本组首位并发症和死因(2.6%),它与术前心功能(Ⅳ级),LXEDD>8.0cm、LVEF<0.4、CTR>80%、急诊手术、心肌保护差、主动脉阻断时间长等密切相关;(2)术后室速、室颤是本组第二位死因(2.1%),表现为突然发生,反复发作,十分顽固;(3)呼吸衰竭;(4)术后出血致心包填塞、休克;(5)术后移植瓣感染和脑部并发症。结论:严格选择病例,改进手术操作,加强围术期监测、抢救,有望提高手术成功率。
目的:分析患者心髒瓣膜轉換術後住院期死亡的原因和相關因素。方法:全組均在全痳低溫體外循環(CPB)下行瓣膜置換術。結果:患者總死亡率9.9%,死亡原因:(1)低心輸齣量綜閤徵是本組首位併髮癥和死因(2.6%),它與術前心功能(Ⅳ級),LXEDD>8.0cm、LVEF<0.4、CTR>80%、急診手術、心肌保護差、主動脈阻斷時間長等密切相關;(2)術後室速、室顫是本組第二位死因(2.1%),錶現為突然髮生,反複髮作,十分頑固;(3)呼吸衰竭;(4)術後齣血緻心包填塞、休剋;(5)術後移植瓣感染和腦部併髮癥。結論:嚴格選擇病例,改進手術操作,加彊圍術期鑑測、搶救,有望提高手術成功率。
목적:분석환자심장판막전환술후주원기사망적원인화상관인소。방법:전조균재전마저온체외순배(CPB)하행판막치환술。결과:환자총사망솔9.9%,사망원인:(1)저심수출량종합정시본조수위병발증화사인(2.6%),타여술전심공능(Ⅳ급),LXEDD>8.0cm、LVEF<0.4、CTR>80%、급진수술、심기보호차、주동맥조단시간장등밀절상관;(2)술후실속、실전시본조제이위사인(2.1%),표현위돌연발생,반복발작,십분완고;(3)호흡쇠갈;(4)술후출혈치심포전새、휴극;(5)술후이식판감염화뇌부병발증。결론:엄격선택병례,개진수술조작,가강위술기감측、창구,유망제고수술성공솔。
Objective: The aim of our study was to analyse the death cause and related factors of death in hospital of patients after cardiac valve replacement (CVR). Methods: Regression analysis of 34 patients' data was executed. Results: Death rate was 9.9 %, death cause: (1) L.ow cardiac output syndrome is the first complication and death cause (2.6 % ), which was closely related to cardiac function (grade Ⅳ ) before operation, LVEDD>8.0 cm, LVEF<0. 40, GR >80%, emergency operation, long time of arterial block, etc; (2) Ventricular tachycardia、 ventricular fibrillation is the second cause of death (2. 1%); (3) Respiratory failure (4) Post-operation hemorrhage inducing pericardial tamponade and shock; (5) Postoperation infection of replaced valve and brain complications. Conclusion: The success rate of operation can be increased by selecting patients strictly, improving operation methods, enhancing periopertive monitor.