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人工心脏机械瓣膜慢性梗阻合并急性功能障碍的外科诊治
唐杨烽,宋智钢,徐激斌,徐志云*
0
(第二军医大学长海医院胸心外科,上海 200433)
摘要:
目的探讨人工心脏机械瓣膜慢性梗阻基础上合并急性功能障碍的早期外科诊断及治疗,提高对人工瓣膜置换术后机械瓣膜慢性梗阻的认识。方法回顾和总结诊治人工心脏机械瓣膜慢性梗阻合并急性功能障碍5例患者的临床资料,并复习相关文献资料。结果5例患者明确诊断后,通过限期手术(再次瓣膜置换手术)治疗,恢复顺利,无一例出现早期相关并发症,术后心功能状况改善明显。结论对于人造心脏机械瓣膜置换术后的患者远期出现类似于瓣膜狭窄的病理生理改变及相关的临床症状时,应高度怀疑慢性梗阻可能;其合并出现急性功能障碍时诊断并不困难,应争取时间尽快再手术,这是挽救患者生命的重要手段。
关键词:  心脏机械瓣膜  慢性梗阻  急性功能障碍  再次手术
DOI:10.3724/SP.J.1008.2010.0186
投稿时间:2009-04-08修订日期:2009-12-17
基金项目:
Chronic stenosis of mechanical prosthetic valve complicated with acute dysfunction:diagnosis and surgical treatment
TANG Yang-feng, SONG Zhi-gang, XU Ji-bin, XU Zhi-yun*
(Department of Cardiothoracic Surgery, Changhai Hospital, Second Military Medical University, Shanghai 200433, China)
Abstract:
ObjectiveTo investigate the surgical diagnosis and treatment of chronic stenosis of mechanical prosthetic valve complicated with acute dysfunction, so as to deepen our knowledge on chronic stenosis of mechanical prosthetic valve. MethodsThe clinical data of 5 patients with chronic stenosis of mechanical prosthetic valve complicated with acute dysfunction were retrospectively analyzed, and the relevant literatures were reviewed. ResultsRe-operation (mechanical prosthetic valve replacement) was performed once the diagnoses were confirmed. The patients recovered well; the cardiac function was obviously improved; and there were no early complications. ConclusionChronic stenosis of mechanical prosthetic valve should be strongly suspected when they have symptoms indicating valvular stenosis. Complication of acute mechanical prosthetic valve dysfunction is not difficult to diagnose, and prompt operation is important to save the life of patients.
Key words:  mechanical prosthetic valve  chronic stenosis  mechanical prosthetic valve dysfunction  re-operation