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目的 探讨风湿性心脏病并发心源性恶液质患者瓣膜置换手术的治疗经验。方法 回顾性分析 1994年 7月— 2 0 0 2年 5月手术治疗风湿性心脏病并发心源性恶液质患者 6 3例。结果 术后早期死亡 7例 (11.1% ) ,2 5例术后出现并发症 (39.7% ) ,5 6例存活出院者心功能及全身情况均有明显改善 ,肝、肾功能已恢复正常 ,术后近期效果良好。结论 充分的术前准备、正确选择手术时机、术中加强心肌保护和体外循环管理 ,彻底纠正三尖瓣反流和适当缩小巨大心房 ,术后合理应用血管活性药物及机械通气 ,尽早处理肝、肾功能不全及围术期的营养支持是提高手术疗效的重要措施
Objective To investigate the experience of valvular replacement surgery in patients with rheumatic heart disease complicated with cardiogenic etiology. Methods The clinical data of 63 patients with rheumatic heart disease complicated with cardiac etiology from July 1994 to May 2002 were retrospectively analyzed. Results 7 cases (11.1%) died of early postoperative complications, 25 cases had postoperative complications (39.7%), 56 patients survived discharged heart function and general condition were significantly improved, liver and kidney function has returned to normal, surgery After the recent good results. Conclusion Adequate preoperative preparation, the correct choice of timing of surgery, intraoperative cardioprotection and cardiopulmonary bypass management, to completely correct the tricuspid regurgitation and the proper reduction of a huge atrium, postoperative rational use of vasoactive drugs and mechanical ventilation, the early treatment of liver, Renal insufficiency and perioperative nutritional support are important measures to improve the efficacy of surgery