关键词：心脏外科手术方法；冠状动脉疾病
【摘要】 目的 介绍老年人心脏病外科治疗的体会。 方法 回顾性分析低温体外循环下进行的59例老年人心脏直视手术，其中单纯冠状动脉旁路移植术(CABG)36例，均为多支病变，5例同时行室壁瘤切除术;单纯瓣膜手术18例;瓣膜置换同时CABG3例，左房粘液瘤摘除术及左心室腔内异物取出术各1例。心功能(NYHA分级)Ⅱ级3例,Ⅲ级38例,Ⅳ级18例。 结果 术后住院死亡2例，存活57例，随访3个月至4年，死亡1例，其余56例生活质量提高,心功能改善，Ⅰ级24例，Ⅱ级30例,Ⅲ级2例。 结论 年龄并非心脏直视手术的禁忌证，经过积极的围手术期处理,大部分患者可取得良好效果。
Open heart operations in 59 elderly patients
YAO Jianmin, CHENG Qirun, JIA Qingren, et al.Department of Cardiac Surgery, General Hospital of Beijing Military Region, Beijing 100700
【Abstract】 Objective To introducethe experience in open heart operations in elderly patients. Methods FromJune 1993 to April 1998, open heart operations were performed with hypothermiccardiopulmonary bypass in 59 elderly patients.Thirty-six cases underwent isolated coronaryartery bypass grafting,5 cases had combined left ventricular aneurysmectomy. Eighteencases underwent isolated valve operations. Three cases had coronary artery bypass graftingwith concomitant valve replacement. One had excision of left atrial myxomas and 1 hadremoval of left ventricular foreign body. Results There were 2hospital mortalities. Of the 57 cases survived the operation, 1 died of cerebrovascularaccident. All the others showed improvement in cardiac function and quality of life duringa follow-up of 3 months to 4 years. Conclusions Elderlies are notcontraindicated for open heart operation; most of the patients can get satisfactoryresults by active perioperative management
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