心脏闭合伤致心室间隔缺损或瓣膜腱索断裂的外科治疗  

Surgical Treatment of Ventricular Septal Defect and Chordae Tendonae Rupture Caused by Close Cardiac Trauma

作　　者：李惠君[1] 邢力[1] 赵瑞[1] 王伯杰[1] 邱莉[1] 

机构地区：[1]吉林省人民医院心外科

出　　处：《中国循环杂志》1997年第5期370-371,共2页Chinese Circulation Journal

摘　　要：目的：探讨心脏闭合伤致心室间隔缺损或瓣膜腱索断裂的临床特点及手术治疗方法。方法：１５年间，共收治心脏外伤４２例。其中心脏闭合伤致心内结构损伤８例，占１９％。这８例中二尖瓣腱索断裂４例，三尖瓣瓣叶破裂或腱索断裂２例，肌部心室间隔缺损２例。回顾性地分析８例患者的原始临床资料。结果：８例患者中，行二尖瓣成形术２例，三尖瓣成形术２例，二尖瓣替换术２例，心室间隔缺损修补术２例，全组无早期死亡。结论：对肌部心室间隔缺损的修补，最好在伤后８周进行。瓣膜腱索断裂者，首选的方法是瓣膜成形术且早期手术有利于患者的恢复。二维及彩色超声心动图结合使用是诊断此病最为简便有效的方法。Objective:To study the clinical feature and surgical treatment of ventriculur septal defect (VSD) and chordae tendonae rupture caused by close cardiac trauma. Methods:42 cases of cardiac trauma were treated in this hospital in the past 15 years,among them there are 8 cases of VSD and ruptured chordae tendonae caused by close cardiac trauma,which accounts for 19% of all cardiac trauma patient.There were 4 cases of muscular VSD.Clinical data of 8 cases were analyzed retrospectively. Results:In 8 cases,mitral valvuloplasty(MVP)was done in 2,tricuspid valvuloplasty(TVP)in 2,mitral valve replacement(MVR)in 2 and repair of VSD in 2.There was no early mortality. Conclusion:The best time of repairing muscular VSD is 8 weeks after trauma.The first choice in ruptured chordae tendonae is valve repair and early operation can improve convalescence.The most convenient and efficient method for diagnosis is color ultrasonography.

关 键 词：心脏损伤 心室间隔缺损 瓣膜腱索断裂 外科手术 

分 类 号：R654.2[医药卫生—外科学]