CAJ | 학술논문

目的分析二尖瓣置换术后发生左心室破裂的高危因素、原因、转归,总结治疗经验.方法回顾性分析江门市中心医院2000年1月-2010年12月期间856例接受二尖瓣置换及二尖瓣、主动脉瓣联合置换手术患者的临床资料,共有3例(0.35%)发生术后左心室破裂,其中早期破裂2例、延迟性破裂1例.早期破裂2例均在体外循环心脏停跳下进行修补,1例采用单纯心外缝合修补,1例采用单纯心内修补方法.1例延迟性破裂在监护室紧急开胸探查证实诊断后.在床边采用非体外循环下心外缝合修补.结果 2例死亡,1例存活.存活者为早期破裂患者采用心内修补患者.结论对于左心室破裂的防治目前仍以预防为主.对早期破裂患者可综合应用多种方法提高治疗成功率;延迟破裂者生存率极低,是目前治疗上面临的主要难题;尽早控制出血并恢复重要器官的血流灌注是改善预后的关键.
목적 분석이첨판치환술후발생좌심실파렬적고위인소、원인、전귀,총결치료경험.방법 회고성분석강문시중심의원2000년1월-2010년12월기간856례접수이첨판치환급이첨판、주동맥판연합치환수술환자적림상자료,공유3례(0.35%)발생술후좌심실파렬,기중조기파렬2례、연지성파렬1례.조기파렬2례균재체외순배심장정도하진행수보,1례채용단순심외봉합수보,1례채용단순심내수보방법.1례연지성파렬재감호실긴급개흉탐사증실진단후.재상변채용비체외순배하심외봉합수보.결과 2례사망,1례존활.존활자위조기파렬환자채용심내수보환자.결론 대우좌심실파렬적방치목전잉이예방위주.대조기파렬환자가종합응용다충방법제고치료성공솔;연지파렬자생존솔겁저,시목전치료상면림적주요난제;진조공제출혈병회복중요기관적혈류관주시개선예후적관건.
Objective To analyze the risk factors and treatment experience of left ventricular rupture after mitral valve,replacement.Methods Retrospective analysis of 856 patients with mitral valve replacement,a total of 3cases(0.35%)postoperative rupture of left ventricular.2cases occurred early after surgery,the other case occurred in 4 days after surgery.one patient were sutured in the heart,2 patients were sutured outside the heart.Results 2 patients died,1 patient survival,the survival patient were repaired rupture in the heart early.Conclusion Left ventricular rupture after mitral valve replacement with hish mortality,prevention of preoperative and intraoperative is the most important,take the right treatment can improve survival rate.