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目的 总结我院 79例 18岁以下少儿心脏瓣膜置换术经验 ,探讨少儿瓣膜置换术的方法和效果。方法 回顾性分析我科从 1982年 4月至 2 0 0 2年 8月间 79例接受瓣膜置换术的少儿患者临床治疗资料。年龄 9～ 18( 12 .5± 4.4)岁 ,<14岁 2 4例。先天性 2 2例 ( 2 7.8% ) ,心内膜炎 6例 ( 7.6% ) ,有合并畸形者 2 0例 ( 2 5 .3 % ) ,风湿性 5 1例 ( 64 .6% )。二尖瓣置换 5 0例 ,主动脉瓣置换 15例 ,三尖瓣置换 6例 ,二尖瓣和主动脉瓣双瓣置换 8例。生物瓣置换 2例 ,机械瓣置换 77例。所有机械瓣置换病人均长期口服华法林抗凝。结果 早期死亡 3例 ( 3 .8% ) ;随访 3～ 2 4( 12 .6± 6.4)个月 ,晚期死亡 1例 ( 1.3 % )术后 2年死于感染性心内膜炎 ;其余患者恢复良好。结论 少儿心脏瓣膜置换手术对于瓣膜病变严重 ,不能进行成形手术的患儿是一种安全有效的治疗方法。选择合适的手术方式、同期处理合并畸形、正规的抗凝治疗是提高儿童瓣膜置换手术效果的关键
Objective To summarize the experiences of 79 cases of children under 18 years of age undergoing heart valve replacement in our hospital and to explore the methods and effects of children’s valve replacement. Methods The clinical data of 79 pediatric patients undergoing valvular replacement from April 1982 to August 2002 were retrospectively analyzed. Aged 9-18 (12.5 ± 4.4) years old, <14 years old, 24 cases. There were 22 congenital cases (2 7.8%), 6 cases of endocarditis (7.6%), 20 cases (25.5%) with deformity and 51 cases (64.6%) of rheumatic diseases. Fifty cases of mitral valve replacement, 15 cases of aortic valve replacement, tricuspid valve replacement in 6 cases, mitral and aortic valve replacement in 8 cases. Bioprosthetic valve replacement in 2 cases, mechanical valve replacement in 77 cases. All mechanical valve replacement patients were long-term oral warfarin anticoagulation. Results The early deaths occurred in 3 patients (3.8%). The follow-up ranged from 3 to 24 (12.6 ± 6.4) months. One patient (1.3%) died of infective endocarditis at 2 years after operation. The remaining patients Recover well. Conclusion Children’s heart valve replacement surgery is a safe and effective treatment for children with valvular disease who can not undergo surgery. Select the appropriate surgical approach, simultaneous treatment of deformity, regular anticoagulant therapy is to improve the effect of valve replacement surgery in children key