摘 要: 【目的】探讨心脏瓣膜置换术后患者行妇产科手术的围术期处理要点。【方法】 2008年5月至2012年4 月期间，丽水市中心医院共收治43例心脏瓣膜置换术后行妇产科手术的患者，分析其临床资料，总结围术期处理经验。【结果】 43例患者均顺利完成手术，所有患者术中无输血，无术后近期并发症。其中一例患者术后5月，出现脑梗塞，一例卵巢破裂患者术后3年，再发对侧卵巢囊肿破裂出血。【结论】心脏瓣膜置换术后患者行妇产科手术，需调整抗凝药物，监测凝血功能。术前充分准备，根据病情选择合理的麻醉方式，加强术中监护，充分止血。术后预防感染，及时恢复服用及调整抗凝药物，重视术后镇痛，对出院患者应强调门诊凝血功能监测及随访的重要性。

    关键词:心脏瓣膜置换术；妇产科手术；围术期抗凝处理

    Abstract: Purpose To explore the perioperative management points ofpatients who experienced heart valve replacement operation in gynecology and obstetrics department .Method During May 2008 to April 2012 , there were a total of 43 patients received with cardiac valve replacement before the gynaecology surgery in Lishui central hospital .To analysis the clinical material and summarize perioperative management experience. Result 43 patients were successfully accomplished the operation without blood transfusion and postoperative complications.One patient appearanced of cerebral infarction after 5months of operation ;One case of ovarian cyst rupture recurrented contralateral hemorrhage 3 years after surgery.Conclusion The patients who experienced heart valve replacement operation needed adjusting the anticoagulant drugs before surgery and monitoring the coagulation function. Sufficient preparations are needed before operation according to the severity of reasonable selection of anesthesia, enhancing intraoperative monitoring and thoroughly hemostasis. The postoperative infection prevention was also important, taking and adjustmenting the dose of the anticoagulant medication.Pay attention to postoperative analgesia.To emphasize the importance of ambulatory monitoring of coagulation function and follow-up visit to discharged patients. ......