摘要
目的回顾性总结本院自2010年罗征祥心血管中心成立以来开展的复杂重症心脏手术、围手术期治疗及手术方法的应用等综合治疗体会。方法实施心脏手术316例,包括复杂重症心脏手术:大血管手术、冠脉搭桥、复杂先天性心脏病及重症风湿性心脏病联合瓣膜病变并肺动脉高压的体外循环心内直视手术,并对施行了主动脉夹层动脉瘤经皮主动脉腔内覆膜支架置入术(ESG),取得的良好效果进行综合总结。结果本组316例早期死亡3例,低心排综合征15例,应用主动脉球囊反搏3例,术后随访3～24个月,心功能恢复均达到Ⅰ～Ⅱ级。结论针对我们在基层医院开展复杂重症心脏手术的临床处理方法,分别对围手术期心功能治疗、肺动脉高压的治疗、主动脉夹层人造血管置换及植入血管内支架的总结、冠状动脉狭窄的外科处理进行讨论。表明只要掌握了核心技术,基层医院是完全可以开展复杂重症心血管外科手术,手术成功率是有保障的。
Objective A retrospective summary was made on the complex cardiac surgeries for severe heart diseases performed between June 2010 and December 2012 as well as the treatment in the perioperative period and surgical approaches. Methods A total of 316 cases underwent cardiac surgeries. These surgeries included complex cardiac surgeries for severe heart diseases, such as major blood vessel operation, coronary artery bypass grafting, and extracorporeal circulation direct-view inner heart operation for complex congenital heart disease and severe rheumatic heart disease associated with valve disease plus pulmonary arterial hypertension. And the good results achieved by endovaseular stent-grafting （ESG） for aortic dissecting aneurysm were summarized. Results Of the 316 cases, 3 suffered early death, 15 had hypokinemia, and 3 were treated with an intra-aortic balloon pump. The postoperative follow-up was 3-24 months. All the patients had the cardiac function recovering to grade I-II. Conclusion According to the clinical treatment in complex cardiac surgeries for severe heart diseases performed in the primary hospital, this paper summarizes the cardiac function therapy in the perioperative period, treatment of pulmonary arterial hypertension, prosthetic vessel replacement for aortic dissection, ESG, and surgical approach to coronary artery stenosis. It suggests that with core technology, the complex cardiac surgeries for severe heart diseases can also be fulfilled in the primary hospital, and the success rate of operation can be ensured.
出处
《心血管病防治知识（学术版）》
2013年第1期17-20,共4页
Prevention and Treatment of Cardiovascular Disease
关键词
重症心脏瓣膜疾病
大血管疾病
复杂先天性心脏病
冠心病
心脏外科手术
Severe heart valve disease
Major blood vessel disease
Complex congenital heart disease
coronary heart disease
Cardiac surgery
