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目的 探讨儿童心脏瓣膜置换术的手术适应证、瓣膜选择和术后抗凝等问题。方法 总结２１例１６岁以下儿童人工心脏瓣膜置换术的经验。结果 全组长期存活１９例，死亡２例。除１例术后发生颅内出血、右室室壁瘤外，其余患者心功能均恢复良好，无１例因生长发育出现人工瓣膜相对狭窄，无１例发生抗凝引起的血栓或出血并发症。结论 儿童人工心脏瓣膜置换术在慎重掌握手术适应证的基础上，应有较好的临床效果；儿童心脏瓣膜置换宜选择机械瓣。
Objective To investigate the surgical indications, valve selection and postoperative anticoagulation in children with heart valve replacement. Methods The experience of 21 cases of prosthetic heart valve replacement in children under 16 years old was summarized. Results The whole group survived in 19 cases and died in 2 cases. In addition to one case of intracranial hemorrhage occurred after surgery, right ventricular aneurysm, the rest of the patients were recovered to good heart function, no growth and development of artificial valve due to the relative stenosis, no case of anticoagulation caused by thrombosis or bleeding complications. Conclusion Children’s prosthetic heart valve replacement surgery should have a good clinical effect on the basis of judicious surgical indications; mechanical valve should be selected for children’s heart valve replacement.