摘要
１９８４年１２月～１９９１年１２月施行心脏人工瓣膜替换术２５２例，术前心功能Ⅱ级占２．４％、Ⅲ级５３．６％、Ⅳ级４４．０％；心胸比率＞０．７０者４２．５％。行二尖瓣替换术１５４例，主动脉瓣替换术２０例，二尖瓣和主动脉瓣替换术７８例；同时行三尖瓣环成形术和／或三尖瓣交界切开术８７例。早期死亡２３例（９．１２％）。２２３例随访６～９０个月，晚期死亡１５例（６．７２％）。存活的２０８例中心功能Ⅰ级１６５例（７４．Ｏ％）、Ⅱ级３９例（１７．５％）、Ⅲ级４例（１．８％）。本文强调了重症患者的术前准备、手术时机的选择的重要性。
The implantations of 330 artificial cardiac valves in 252 patients were performed from Dec.1984 to Dec.1991.Of which 130 patients were male and 122 female.The age ranged from 11 to 65 years old with an average of 39 years old.The course of disease ranged from 1 to 44 years with an average of 16 years.Among them 225 patients were rheumatic heart diseases,of which isolated mitral valve disease was 147 patients,multiple valve diseases 78 and 27 patients were congenital or degeneration heart diseases.Preoper-ative cardiac function NYHA classification was class Ⅱ in 6 patients(2.4%),class Ⅲ 135(53.6%)and class Ⅳ 111(44.0%).CTR ranged from 0.54 to 0.98 with an average of 0.67,of which an average of CTR was more than 0.70 in 107 patients and more than 0.80 in 20.There were 154 patients with MVR,20 AVR and 78 DVR.87 of them had simulta-neously tricuspid annuloplasty by DeVega’s maneuver and 2 patients with mitral annulo-plasty.Since Feb.1990,37 patients had MVR with preservation of the posterior leaflet and chordae tendineae.The early mortality was 9.12%,Since 1988 the mortality has been reduced to 5.92%.223 patients were followed up from 6 to 90 months.15 patients were late deaths.The late mortality was 6.72%,half of which died from overdose of anticoagu-lant.The cardiac functions of 208 survivors were class Ⅰ in 165 patients,class Ⅱ 39 and class Ⅲ 4.
出处
《中日友好医院学报》
1994年第1期10-13,共4页
Journal of China-Japan Friendship Hospital
关键词
风湿性心脏病
人工瓣膜
置换术
rtificial cardiac valve replacement
rheumatic heart disease
anticoagulation
