浙江临床医学
浙江臨床醫學
절강림상의학
ZHEJIANG CLINICAL MEDICAL JOURNAL
2013年
11期
1627-1629
,共3页
高龄患者%心脏瓣膜病%心脏瓣膜置换术
高齡患者%心髒瓣膜病%心髒瓣膜置換術
고령환자%심장판막병%심장판막치환술
Aged patients%Heart valve disease%Heart valve replacement
目的：总结62例高龄患者心脏瓣膜病的手术治疗及结果。方法2012年2月至2013年1月心脏大血管外科施行的>60岁高龄患者心脏瓣膜手术的病例，其中行二尖瓣置换31例，主动脉瓣置换23例，二尖瓣联合主动脉瓣置换8例。同期行房颤射频消融术24例，左房血栓清除15例，三尖瓣成形术29例，左房折叠31例。共置换瓣膜70枚，生物瓣59枚、机械瓣11枚。结果术后早期死亡2例，病死率3.22%（2/62）。术后并发症：低心排血量综合征4例，呼吸功能不全8例，心律失常19例，急性肾功能不全8例，精神症状3例，无并发脑血管意外、切口愈合不良、精神症状，治疗后均痊愈出院。对其中52例患者随访3至8个月。结论只要掌握好手术指证，细致的手术操作，加强围手术期管理，高龄患者心脏瓣膜置换术可以取得良好的效果。
目的：總結62例高齡患者心髒瓣膜病的手術治療及結果。方法2012年2月至2013年1月心髒大血管外科施行的>60歲高齡患者心髒瓣膜手術的病例，其中行二尖瓣置換31例，主動脈瓣置換23例，二尖瓣聯閤主動脈瓣置換8例。同期行房顫射頻消融術24例，左房血栓清除15例，三尖瓣成形術29例，左房摺疊31例。共置換瓣膜70枚，生物瓣59枚、機械瓣11枚。結果術後早期死亡2例，病死率3.22%（2/62）。術後併髮癥：低心排血量綜閤徵4例，呼吸功能不全8例，心律失常19例，急性腎功能不全8例，精神癥狀3例，無併髮腦血管意外、切口愈閤不良、精神癥狀，治療後均痊愈齣院。對其中52例患者隨訪3至8箇月。結論隻要掌握好手術指證，細緻的手術操作，加彊圍手術期管理，高齡患者心髒瓣膜置換術可以取得良好的效果。
목적：총결62례고령환자심장판막병적수술치료급결과。방법2012년2월지2013년1월심장대혈관외과시행적>60세고령환자심장판막수술적병례，기중행이첨판치환31례，주동맥판치환23례，이첨판연합주동맥판치환8례。동기행방전사빈소융술24례，좌방혈전청제15례，삼첨판성형술29례，좌방절첩31례。공치환판막70매，생물판59매、궤계판11매。결과술후조기사망2례，병사솔3.22%（2/62）。술후병발증：저심배혈량종합정4례，호흡공능불전8례，심률실상19례，급성신공능불전8례，정신증상3례，무병발뇌혈관의외、절구유합불량、정신증상，치료후균전유출원。대기중52례환자수방3지8개월。결론지요장악호수술지증，세치적수술조작，가강위수술기관리，고령환자심장판막치환술가이취득량호적효과。
Objective Summarize the surgical treatment of 62 cases of elderly patients(>60 years)with heart valve disease and Results. Methods Between February 1,2012 to January 1,2013,62 patients aged 60years or older underwent cardiac valve operation. Line of mitral valve replacement 31 cases,23 cases of aortic valve replacement,8 cases mitral valve combined with aortic valve replacement. Line 24 cases of atrial fibrillation radiofrequency ablation during this period,the left atrial thrombus removal of 15 patients,tricuspid valvuloplasty 29 cases,31 cases of left atrial folding.,valve replacement 70 biological disc 59,mechanical valve 11 pieces. Results 61survived(96.78%)and 1 died(3.22%). Postoperative complications: low cardiac output syndrome in 4 cases,8 cases of respiratory insufficiency,arrhythmia(19 cases), acute renal insufficiency,8 cases of mental symptoms(3 cases),complicated with cerebrovascular accident,poor healing of incision,mental symptoms,were recovered from hospital after treatment. 52patients were followed up from 3 months to 8 months. Conclusion Although there are high risks in aged patients with valvular heart disease,the treatment Results could be satisfactory if we are able to select the right operating time and get all preparation with reasonable surgery strategy. The mortality and postoperative complication rate could be less.
