| 殷恩智田伟臣△ 李刚吕航李君权.同期行冠状动脉旁路移植和心脏瓣膜置换术治疗冠心病
合并心脏瓣膜病的临床研究[J].,2014,14(10):1890-1892 |
| 同期行冠状动脉旁路移植和心脏瓣膜置换术治疗冠心病
合并心脏瓣膜病的临床研究 |
| Clinical Study on the Synchronous Cardiac Valve Operation plus CoronaryArtery Bypass Grafting in the Treatment of Coronary Heart DiseaseCombined with Valvular Heart Disease |
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| DOI： |
| 中文关键词: 心脏瓣膜病 冠状动脉性心脏病 冠状动脉旁路移植术 瓣膜置换术 |
| 英文关键词: Valvular heart disease Coronary heart disease Coronary artery bypass grafting (CABG) Valve replacement Cardiac
surgical procedures |
| 基金项目: |
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| 中文摘要: |
| 摘要目的：总结同期行冠状动脉旁路移植(CABG)和心脏瓣膜置换术治疗冠心病合并心脏瓣膜病的临床经验。方法：回顾性分析
我院收治的41 例接受冠状动脉旁路移植同期行心脏瓣膜置换术的冠心病合并心脏瓣膜病患者的临床资料，对手术方法、主要并
发症和术后处理方法进行分析总结。结果：41 例患者中，行二次开胸4 例(9.76%)，应用IABP 2例(4.88%)，发生低心排综合征6 例
(14.63%)、肾功能不全6 例(14.63%)、肺功能不全7 例(17.07%)、脑合并症1 例(2.44%)、胸腔积液4 例(9.77%)，死亡6 例(13.63%)，
其余患者康复出院。结论：CABG 同期行心脏瓣膜置换术治疗冠心病合并心脏瓣膜病的近期疗效满意。术前改善心功能，成熟的
手术技术，完全的心肌再血管化，良好的心肌保护，停机困难者尽早应用主动脉内球囊反搏(IABP)及加强术后处理是提高CABG
同期行心脏瓣膜置换术疗效的重要措施。 |
| 英文摘要: |
| ABSTRACT Objective:To summarize the clinical experience of synchronous Cardiac Valve Operation plus Coronary Artery Bypass
Grafting in the treatment of coronary heart disease combined with valvular heart disease. Methods:A retrospective study was carried
out to review 41 cases of coronary artery disease combined with valvular heart disease that underwent synchronous CABG plus cardiac
valve replacemem. The surgical technique complications and post-operative treatment were analyzed.Results: Early post-operative
complication included: re-open in 4 cases(9.76%), LCOS in 6 cases(14.63%), IABP used in 2 cases(4.88%), renal insufficiency in 6 cases
(14.63%), respiratory insufficiency in 7 cases (17.07%), complication of CNS in 1 case (2.44%), pleural effusion in 4 cases (9.77%) and
death in 6 cases (13.63%). The others had favorable outcomes. Conclusion:Synchronous CABG combined with cardiac valve
replacement showed a good early outcome in the treatment of patients with coronary artery disease combined with valvular heart disease.
Preoperative improvement of heart function, perfect surgical technique, complete transmyocardial laser revascularization, effective
myocardial protection, early application of IABP on the patients who was difficult to wean from pump could significantly improve the
efficacy of CABG combined with cardiac valve replacement in the treatment of coronary heart disease combined with valvular heart
disease.
Valvular |
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