摘要
目的 总结风湿性心脏瓣膜病合并心源性恶液质病人的围手术期治疗经验。方法 回顾性分析近 6年 42例心脏恶液质瓣膜患者的围手术期治疗。结果 术后早期死亡 4例( 9 .5 2 % ) ,2 0例术后出现并发症 ,3 8例患者出院时肝脾明显缩小 ,食欲好转 ,血红蛋白、血浆蛋白及肝、肾功能正常。随访 10个月～ 6年 ,心功能恢复至Ⅰ级 2 4例 ,Ⅱ级 14例。结论 充分的术前准备、围术期营养支持 ,正确地选择好手术时机 ,加强术中处理 ,积极治疗术后并发症是提高手术疗效的关键。
Objective To review the experience of perioperative and surgical treatment of the rheumatic valvular heart disease with cardiac cachexia.Methods During the last 6 years,mitral and/or aortic valve replacement were performed in 42 patients with rheumatic valvular heart disease combined with cardiac cachexia.A retrospective analysis was made in all patients.Results There were 4 early operative deaths with a mortality rate of 9.52% and 20 patients of all with various complications after operation.The remaining 38 patients had an uneventful recovery and were discharged with normal liver and renal function.All survivors had clinical improvement during a follow-up of 10 month to 15 years.Heart function was class I in 15 patients and class II in 14 patients.Conclusion The patients with cardiac cachexia are susceptible to the various complications after operation.Their nutrition and heart function must be improved in perioperatively.The myocardial protection and tricuspid treatment should be strengthened in operation.Treatment of postoperative complications is critical for the surgical results.
出处
《临床外科杂志》
2004年第9期547-548,共2页
Journal of Clinical Surgery
关键词
风湿性心脏瓣膜病
恶液质
瓣膜置换
围手术期
rheumatic valvular heart disease
cardiac cachexia
valve replacement
perioperative period
