卵圆孔未闭与反常栓塞  

Patent Foramen Ovale and Paradoxical Embolism

作　　者：黄旭中[1] 

机构地区：[1]四川大学华西医院胸心血管外科,成都610041

出　　处：《中国胸心血管外科临床杂志》2005年第1期42-45,共4页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：一般情况下 ,卵圆孔未闭 (patent foramen ovale)不引起心房间分流 ,不需外科手术。近年来的研究发现 ,卵圆孔未闭的存在与反常栓塞、缺血性脑卒中的发生密切相关 ,与冠状动脉旁路移植术及各种心、肺手术后不明原因的卒中或猝死相关的报道日益增多。除神经科、心内科医生对其十分重视外 ,心胸外科、麻醉科医生亦已予以关注。现将近年在卵圆孔未闭、房间隔动脉瘤、反常栓塞的发生机制、临床表现、诊断和治疗方面的新进展进行综述 ,旨在拓宽对心胸手术后突然出现不明原因的卒中或短暂性脑缺血、冠状动脉反常栓塞导致的急性心肌梗死、肺栓塞等合并症时能正确思考和采取及时有效的处理对策。In general, surgical closure of patent foramen ovale （PFO） in patients without inter-atrial shunt is unnecessary. There is a strong association of PFO with paradoxical embolism （PDE） and ischemic cerebral infarction, and reports on patients with PFO related cryptogenic stroke after coronary artery bypass grafting and various surgical cases of heart or lung are being increasingly published in recent years. These findings powered the interest of anesthesiologists, and cardiothoracic surgeons, in spite of the fact that numerous neurologist and cardiologist have greatly payed attention to these events already. This article surveys the current advance of knowledge to delineate the principal mechanism, clinical presentation, diagnostic strategies and treatment options in patients with PFO, atrial septal aneurysm and PDE, and focuses on careful consideration and effective management of patient who was suddenly presented with a cryptogenic stroke or transient ischemic attack followed by cardiothoracic operations.

关 键 词：卵圆孔未闭 反常栓塞 房间隔动脉瘤 卒中 

分 类 号：R654.2[医药卫生—外科学]