前言目的探讨重度二尖瓣病变合并功能性三尖瓣关闭不全合理手术指征、方法及围手术期处理。方法回顾分析三尖瓣成形矫正功能性三尖瓣关闭不全84例,男性52例,女性32例,年龄12～69岁,其中采用Devega成形30例,节段性Devega成形34例,Key’s成形和改良Key’s成形各10例。同时施行二尖瓣置换52例,二尖瓣+主动脉瓣置换32例。结果术后早期死亡4例,死亡率48%;迟发性心包压塞6例均经心包引流治愈。随访3个月～15年,获访66例,2例死于顽固性心力衰竭,其余心功能均明显改善。超声心动图示右心房右心室较术前明显缩小。26例三尖瓣仍有轻、中度反流。结论根据三尖瓣环扩大部位和反流程度,选择不同成形方式对功能性三尖瓣关闭不全治疗满意。围手术期及术后加强强心、利尿、扩血管治疗及有效降低肺动脉高压,可进一步提高三尖瓣成形近、远期疗效。
Objective:Todiscusstheoperativeindication,proceduresandperi\|operativecareoffunctionaltricuspidinsufficiency（FTI）succeedingtorheumaticvalvedisease.Method:Tricuspidvalveanuloplastywasperformedin84caseswithFTI.52weremalesand32females,aged12～69yearsold.Devegaprocedurewasperformedin30cases,segmentalDevegain34cases.KayprocedureandimprovedKayprocedurein10casesrespectively.Associatedprceduresincludedmitralvalvereplacementin52casesandcombinedaortican...
