[摘要]目的 探讨风湿性三尖瓣病变外科治疗的手术时机、方法和疗效。方法 1990年1月～2005年6月，我院行手术治疗风湿性三尖瓣病变病人139例，其中三尖瓣器质性病变21例，功能性三尖瓣关闭不全(TI)118例，手术采用三尖瓣成形术(TVP)125例，三尖瓣置换术(TVR)14例。结果 术后早期死亡10例，手术死亡率为7.19%。术后随访116例，平均随访时间(31.5±11.1)月。远期死亡3例，余113例远期存活者心功能Ⅰ级者23例，Ⅱ级者72例，Ⅲ级者16例，Ⅳ级者5例。X线胸片示心胸比率0.41～0.87，平均0.62±0.27，较术前明显减小( t′=3.16，P <0.05)。结论 风湿性心脏病并发三尖瓣病变时应同时进行三尖瓣手术。三尖瓣无论是器质性或功能性病变，多数可以行TVP，对无法行成形术的病例应行TVR。三尖瓣手术早期和晚期死亡的重要原因为右心衰竭与心律失常，围手术期应加强右心功能的维护和心律失常的防治。

    [关键词] 风湿性心脏病;三尖瓣病变;瓣膜成形术;瓣膜置换术

    SURGICAL TREATMENT OF RHEUMATIC TRICUSPID DISEASE

    LI JUN， LI PEI-JIE， WANG MING-HUA， et al

    (De-partment of Cardiovascular Surgery， Shandong Provincial Qianfoshan Hospital， School of Clinical Medicine， Shandong University， Ji′nan 250014， China)

    [ABSTRACT]ObjectiveTo assess the occasion， method and effect of surgical treatment of rheumatic tricuspid disease. MethodsFrom January 1990 to June 2005， 139 cases of tricuspid valve operations were performed for rheumatic tricuspid disease， which included 21 cases of organic tricuspid disease and 118 cases of functional tricuspid valve incompetence. Of all the patients， 125 underwent valvuloplasty and 14 valve replacement. ResultsTen patients died early after operation ......