超声心动图评价心肌梗死后室间隔穿孔  

Evaluation of Perforation of Interventricular Septum in Myocardial Infarction with Echocardiography

作　　者：费洪文[1] 何亚乐[1] 侯跃双[1] 黄新胜[1] 许燕[1] 郑智超[1] 龚静吉[1] 

机构地区：[1]广东省心血管病研究所,广东省人民医院心内科,广东省医学科学院,广州市510100

出　　处：《中国超声医学杂志》2010年第3期200-202,共3页Chinese Journal of Ultrasound in Medicine

基　　金：广东省医学科研基金(No.A2009044)

摘　　要：目的评价超声心动图对于心肌梗死后室间隔穿孔的诊断价值,并对比室间隔穿孔外科修补组与非外科修补组30 d生存率。方法 2000年～2009年本心脏中心的心肌梗死后室间隔穿孔住院患者49例,年龄45～78岁,平均66岁,男27例,女22例。急诊室间隔修补手术32例,将术前急诊超声心动图结果与术中结果进行对比。并对比室间隔外科修补组与非外科修补组患者30 d生存率。结果 32例室间隔外科修补患者,超声诊断室间隔穿孔的准确率100%,穿孔部位的判定率96%,对于合并室壁瘤的准确率93%。室间隔外科修补组患者30 d生存率71.9%(23/32),未行室间隔修补30 d生存率41.2%(7/17)。结论超声心动图对室间隔穿孔具有重要诊断价值,紧急外科修补手术,可明显提高30 d生存率。Objective To investigate the role of echocardiography in the diagnosis of interventricular septum perforation in myocardial infarction and compare 30-day survival rate between surgical group and non-surgical group. Methods Forty-nine cases of interventricular septum perforation associated with myocardial infarction were diagnosed in our cardiovascular center between 2000-2009.27 males and 22 females with average 66ys （45-78ys） . 32 cases underwent successful ventricular septal defect closure and/or coronary artery bypass. We compared the echocardiographic diagnosis to the surgical view and compared the 30-day survival rate between surgical and non-surgical group. Results In 32 surgical cases, echocardiography evaluated accuracy rate for interventricular septum perforation was 100%, perforation site 96%, and ventricular aneurysm 93%.30 day survival rate of surgical group was 71.9% （23/32） while non-surgical group was 41.2% （7/17）. Conclusions Echocardiography plays an important role in the diagnosis of interventrieular septum perforation in myocardial infarction which needs emergency surgical septal defect closure and can increase 30-day survival rate significantly.

关 键 词：超声心动图 室间隔穿孔 心肌梗死 

分 类 号：R540.45[医药卫生—心血管疾病] R542.22[医药卫生—内科学]