8例心内膜心肌纤维化的诊疗经验  

The experience of diagnosis and treatment of 8 cases of endomyocardial fibrosis

作　　者：梁葳[1] 王茂生[1] 秦太昌[1] 李韬[1] 

机构地区：[1]茂名市人民医院心胸外科,广东茂名525000

出　　处：《心肺血管病杂志》2005年第1期18-20,共3页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的总结8例心内膜心肌纤维化(EMF)的诊断和治疗经验。方法对有不明原因的心力衰竭并考虑为EMF的8例患者施行超声心动图(UCG)、核磁共振成象(MRI)、心内膜心肌活检(EMB)等检查,4例予内科治疗,4例行外科手术。结果UCG、MRI及EMB获得EMF诊断的例数分别为3/8,4/4及3/4,同时行以上3种检查诊断的例数为3/3。4例经内科治疗,2周至6个月内全部死亡。2例施行右心室心内膜切除加三尖瓣成形术,术后恢复良好,随访6～9年,心功能2级,能从事轻度工作。2例行右心室心内膜切除加三尖瓣置换术,手术死亡1例,1例存活6年,死于心力衰竭。结论综合应用UCG、MRI及EMB可提高EMF的诊断率,对病变较轻的EMF患者行心内膜切除加瓣膜成形或置换术可获得良好的效果,对病变重的病例应行心脏移植。Objective:To report the experience of diagnosis and treatment of 8 cases of endomyocardial fibrosis(EMF).Method:Echocardiography(UCG),magnetic resonance imaging(MRI)and endomyocardial biopsy(EMB) were performed in 8 patients who presented heart failure of unknow etiology and had been considered as EMF.4 cases received physician therapy,and 4 cases underwent surgical operation.Result:The results showed that the diagnosis cases'number of UCG,MRI,EMB for EMF and 3/8,4/4,3/4,respectively.The diagnosis cases' number of complehensive utilizing UCG,MRI and EMB are 3/3.4 patients who received physician therapy died of heart failure within two week to half a year.Right ventricular endocardiectomy and tricuspid valve repair have been performed in 2 patients with mild EMF.They recovered well postoperatively.The follow\|up was six to nine years,and revealed that cardiac function improved to 2 class,and they were able to do little work.Right ventricular endocardiectomy and tricuspid valve replacement had been performed in 2 patients with severe EMF.There was one death.Another patient survived six years and died of heart Failure.Conclusion:Comprehensive utilizing UCG,MRI and EMB to examination can improve the diagnostic rate of EMF.Ventricular endocardiectomy and valve repair or replacement were performed in patients with mild EMF should get good result,the patient with severe EMF should receive heart transplant.

关 键 词：心内膜心肌纤维化 诊疗技术 心脏移植 心内膜切除术 瓣膜成形术 

分 类 号：R542.23[医药卫生—心血管疾病]