CAJ | 학술논문

目的总结90例成人心脏瓣膜置换术早期治疗上的一些体会，探讨提高瓣膜置换术后早期生存率的措施。方法选择2011年1月至2011年8月行瓣膜置换术的患者90例，术后入住ICU，呼吸机辅助呼吸，连续多项指标监测,常规血管活性药物辅助，维持血压在术前水平，控制心室率80~100次/分。结果二次开胸止血患者5例，大量心包积液患者5例，恶性心律失常患者3例，肺部感染患者3例，急性肾功能衰竭患者4例。术后早期存活患者共85例（存活率94.44%），死亡5例（5/90，5.55%）。结论对心脏瓣膜病患者的手术，特别是重症患者，提高手术技能、加强术中心肌保护、严密术后治疗的各种环节，及时处理早期并发症是提高患者早期生存率的关键。
목적총결90례성인심장판막치환술조기치료상적일사체회，탐토제고판막치환술후조기생존솔적조시。방법선택2011년1월지2011년8월행판막치환술적환자90례，술후입주ICU，호흡궤보조호흡，련속다항지표감측,상규혈관활성약물보조，유지혈압재술전수평，공제심실솔80~100차/분。결과이차개흉지혈환자5례，대량심포적액환자5례，악성심률실상환자3례，폐부감염환자3례，급성신공능쇠갈환자4례。술후조기존활환자공85례（존활솔94.44%），사망5례（5/90，5.55%）。결론대심장판막병환자적수술，특별시중증환자，제고수술기능、가강술중심기보호、엄밀술후치료적각충배절，급시처리조기병발증시제고환자조기생존솔적관건。
Objective To summarize 90 cases of adult cardiac valve replacement early experiences of treatment, to explore the early survival rate increased after valve replacement measures. Methods 90 cases of patients in 2011 January ~2011 year in August for valve replacement, postoperative stay in ICU, mechanical ventilation, for a number of indicators for monitoring, routine of vasoactive drugs, to maintain blood pressure in the preoperative level, controlling ventricular rate 80~100 times/points. Results Two patients with thoracic bleeding in 5 cases, 5 cases of pericardial effusion, 3 cases of patients with malignant arrhythmia, pulmonary infection in 3 cases, 4 cases of patients with acute renal failure. Early survival in patients with a total of 85 cases of postoperative ( the survival rate was 94.44%), 5 cases of death (5\/90,5.55%). Conclusion The patients with valvular heart disease operation, especially in critically ill patients, improve operation skills, various aspects of strengthening the intraoperative myocardial protection, close postoperative treatment, timely treatment of complications in early stage is the key to improve the survival rate of patients in early stage.