摘要
目的 探讨双瓣膜置换和三尖瓣成形术中减少心肌缺血时间的手术方法。方法 1999年 1月至 2 0 0 3年 5月 ,66例多瓣膜病变病人在全身浅中低温和心肌局部深低温体外循环下心内手术 ,二尖瓣置换均经房间隔径路 ,采用连续缝合法。主动脉瓣置换采用连续缝合用 3根线 5 6例、1根线 3例和间断褥式带垫缝合 7例。在开放主动脉后行三尖瓣成形。同时行左房血栓清除术17例。结果 全组置入人工机械瓣膜 13 2枚 ,主动脉阻断时间平均 ( 3 4 5± 4 3 )min分钟。转流时间平均 ( 5 6 1± 7 8)min。除 1例体外循环中发生胰肽酶过敏 ,需用阿拉明和大剂量激素外 ,手术及体外循环停机顺利。无一例住院死亡和严重并发症发生。结论 通过改进手术方法和提高手术技巧 ,可使心肌缺血和转流时间大幅度减少 。
Objective To investigate the operation experience of reducing time of heart clamp in double valve replacement and tricuspidplasty in 66 patient. Methods From May 1999 to March 2003, 66 patients received mitral valve replacement(MVR), aortic valve replacement(AVR) and tricuspidplasty. Mitral valves were replaced by continuous suture. Aortic valves were replaced by continuous suture in 59 cases and interrupted suture in 7 cases. Results 132 artificial valves were grafted. The time of aortic clamp and pump was 34.5±4.3 minutes and 56.1±7.8 minutes respectively. There were no postoperative severe complications and death in all 66 cases in hospital. Conclusions Decreasing the time of aortic clamp and pump is good for myocardium protection and may reduce postoperative complications.
出处
《中国医师杂志》
CAS
2004年第1期34-36,共3页
Journal of Chinese Physician
