目的 總結老年危重心瓣膜病患者的手術治療和圍術期處理經驗。 方法 回顧性分析 2008年6月至2010年6月中國醫科大學附屬第一醫院37例60歲以上老年危重心瓣膜病患者手術治療的臨床資料,其中男21例,女16例;年齡60~79 (67.3±6.9)歲。二尖瓣病變15例,主動脈瓣病變8例,主動脈瓣+二尖瓣病變14例;合并左心房血栓9例,三尖瓣反流11例。 結果 圍術期死亡3例,其中死于術后肺部感染1例,多器官功能衰竭1例,腦梗死1例。術后發生并發癥18例,包括呼吸道并發癥、室性心律失常、低心排血量綜合征和急性腎功能衰竭等,經相應的治療治愈。隨訪26例,隨訪時間6~23個月,心功能分級(NYHA)Ⅰ級13例,Ⅱ級12例,Ⅲ級1例。 結論 完善的術中操作、加強圍術期處理,可有效降低老年危重心瓣膜病患者術后并發癥的發生和病死率。
引用本文:
房勤,谷天祥,劉波,王春,張玉海,盧春茂. 老年危重心瓣膜病的外科治療與圍術期處理. 中國胸心血管外科臨床雜志, 2013, 20(1): 111-112. doi:
復制
1. |
mitral valve disease:epidemiology and prognostic implications. Semin Thorac Cardiovasc Surg, 2010, 22 (1):69-75.
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2. |
Srinivasan AK, Oo AY, Grayson AD, et al. Mid-term survival after cardiac surgery in elderly patients:analysis of predictors for increased mortality. Interact Cardiovasc Thorac Surg, 2004, 3 (2):289-293.
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3. |
許鎖春, 閆煬, 耿希剛, 等. 急診外科手術治療危重心瓣膜病192例. 中國胸心血管外科臨床雜志, 2009, 16 (4):312-314.
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4. |
Martínez-Sellés M, Hortal J, Barrio JM, et al. Treatment and outcomes of severe cardiac disease with surgical indication in very old patients. Int J Cardiol, 2007, 119 (1):15-20.
|
5. |
Conti V, Lick SD. Cardiac surgery in the elderly:indications and management options to optimize outcomes. Clin Geriatr Med, 2006, 22 (3):559-574.
|
6. |
Urban M, Pirk J, Turek D, et al. In patients with concomitant aortic and mitral valve disease is aortic valve replacement with mitral valve repair superior to double valve replacement? Interact Cardiovasc Thorac Surg, 2011, 12 (2):238-242.
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7. |
程實, 修宗誼, 谷天祥, 等. 重癥心臟瓣膜病心瓣膜置換術體外循環經驗. 中國胸心血管外科臨床雜志, 2009, 16 (5):402-402.
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8. |
Anderson AJ, Barros Neto FX, Costa Mde A, et al. Predictors of mortality in patients over 70 years-old undergoing CABG or valve surgery with cardiopulmonary bypass. Rev Bras Cir Cardiovasc, 2011, 26 (1):69-75.
|
9. |
Anyanwu AC, Adams DH. Functional tricuspid regurgitation in.
|
10. |
Lindqvist P, Zhao Y, Bajraktari G, et al. Aortic valve replacement normalizes left ventricular twist function. Interact Cardiovasc Thorac Surg, 2011, 12 (5):701-706.
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11. |
Kovács E, Becker D, Daróczi L, et al. Analysis of vascular complications of IABP therapy in open-heart surgery patients 1999-2004. Magy Seb. 2006, 59 (2):105-111.
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- 1. mitral valve disease:epidemiology and prognostic implications. Semin Thorac Cardiovasc Surg, 2010, 22 (1):69-75.
- 2. Srinivasan AK, Oo AY, Grayson AD, et al. Mid-term survival after cardiac surgery in elderly patients:analysis of predictors for increased mortality. Interact Cardiovasc Thorac Surg, 2004, 3 (2):289-293.
- 3. 許鎖春, 閆煬, 耿希剛, 等. 急診外科手術治療危重心瓣膜病192例. 中國胸心血管外科臨床雜志, 2009, 16 (4):312-314.
- 4. Martínez-Sellés M, Hortal J, Barrio JM, et al. Treatment and outcomes of severe cardiac disease with surgical indication in very old patients. Int J Cardiol, 2007, 119 (1):15-20.
- 5. Conti V, Lick SD. Cardiac surgery in the elderly:indications and management options to optimize outcomes. Clin Geriatr Med, 2006, 22 (3):559-574.
- 6. Urban M, Pirk J, Turek D, et al. In patients with concomitant aortic and mitral valve disease is aortic valve replacement with mitral valve repair superior to double valve replacement? Interact Cardiovasc Thorac Surg, 2011, 12 (2):238-242.
- 7. 程實, 修宗誼, 谷天祥, 等. 重癥心臟瓣膜病心瓣膜置換術體外循環經驗. 中國胸心血管外科臨床雜志, 2009, 16 (5):402-402.
- 8. Anderson AJ, Barros Neto FX, Costa Mde A, et al. Predictors of mortality in patients over 70 years-old undergoing CABG or valve surgery with cardiopulmonary bypass. Rev Bras Cir Cardiovasc, 2011, 26 (1):69-75.
- 9. Anyanwu AC, Adams DH. Functional tricuspid regurgitation in.
- 10. Lindqvist P, Zhao Y, Bajraktari G, et al. Aortic valve replacement normalizes left ventricular twist function. Interact Cardiovasc Thorac Surg, 2011, 12 (5):701-706.
- 11. Kovács E, Becker D, Daróczi L, et al. Analysis of vascular complications of IABP therapy in open-heart surgery patients 1999-2004. Magy Seb. 2006, 59 (2):105-111.