摘要
目的回顾国内19年来47例急性心肌梗死（枷）并发室间隔穿孔的外科治疗资料，总结分析心肌梗死并发室间隔穿孔的外科治疗方法与疗效。方法检索1989～2005年中文生物医学期刊数据库（CMCC）收录的有关AMI并发室间隔穿孔外科治疗的文献资料，统计分析并总结47例AMI并发室间隔穿孔患者的临床资料。结果47例患者经手术成功救治44例（93．6％），手术死亡3例（6．38％），分别为心力衰竭、心脏破裂和肾功能衰竭。术后随访2个月～8a，死亡3例（6．38％），其中2例为室间隔穿孔修补术后2个月又发现心脏杂音并反复心力衰竭和肺部感染死亡，另1例术后3个月发生肺部感染引起中毒性休克死亡。结论AMI并发室间隔穿孔常常合并室壁瘤，由于病情较危重，掌握手术时机十分重要，穿孔2周以上修补穿孔者比较容易。合并室壁瘤和冠状动脉病变应积极处理，加强心肌保护和主动脉内球囊反搏泵的应用能明显提高术后生存率。
Objective To study data of domestic surgical treatment of interventricular septum perforation after acute.myocardial infarction in the recent 19 years. Methods We retrieved the literature about surgical treatment of interventricular septum perforation after acute myocardial infarction included in CMCC, and summarized the clinical data of 47 patients suffering from interventricular septum perforation after acute myocardial infarction. Results In the 47 cases, 3 patients（ 6.38 % ）died after operation, of whom 1 died from heart failure, 1 died from heart rapture and 1 died from renal failure. 3 patients（6.38% ）died during the follow - up, of whom 2 might suffer the reopening of the perforation, and ldied from toxic shock induced by lung infection. Conclusion Operative opportunity is important in cases of surgical treatment of interventricular septum perforation after acute myocardial infarction. It may be easier to perform the operation up to 2 weeks after perforation. The accompanied aneurysms and coronary lesion should be dealed with actively. The myocardial protection should be strengthened and IABP used to improve the postoperative survival rate.
出处
《中国急救医学》
CAS
CSCD
北大核心
2006年第7期493-495,共3页
Chinese Journal of Critical Care Medicine
关键词
急性心肌梗死
室间隔穿孔
外科治疗
Acute myocardial infarction（AMI）
Interventricular septum perforation
Surgical treatment
