钝性胸外伤致二尖瓣腱索断裂1例及文献复习  

Ruptured mitral chordae tendineae after blunt chest trauma:a case report and review of the literature

作　　者：郭伟[1] 王银凤 陶晓根 

机构地区：[1]中国科学技术大学附属第一医院(安徽省立医院)南区重症医学科,合肥230036

出　　处：《临床急诊杂志》2018年第10期707-708,712,共3页Journal of Clinical Emergency

摘　　要：1病例资料患者,男,70岁,因＂胸闷、发热、咳嗽2周＂于外院就诊,诊断为社区获得性肺炎,行抗感染治疗,症状逐渐加重出现急性左心功能衰竭及肺水肿。入我院前1天患者血氧饱和度下降,呼吸衰竭,气管插管、机械通气抢救,后转入我院重症医学科进一步治疗,既往高血压病史。入院后体格检查：T36.5℃,P 105次/min,R 15次/min（机械通气）,BP 140/75mmHg（1mmHg=0.133kPa）.To analyze clinical diagnostic key point of ruptured mitral chordae tendineae（RMCT）after blunt chest trauma in order to avoid misdiagnosis and missed diagnosis.Clinical data of one patient with RMCT after blunt chest trauma was retrospectively analyzed.Clinical features,misdiagnosis causes,and related literature were reviewed.A month ago,the patient fell down to result in blunt chest trauma,and the patient gradually had chest tightness,fever and coughing.The patient was misdiagnosed as upper respiratory tract infection in local hospital.Although anti-infection therapy was given,but the symptoms were not relieved.The patient was transferred to our hospital due to respiratory failure,and was diagnosed with RMCT by transthoracic echocardiography.The patient accepted the operation to improve the heart function and then recovered.Early clinical manifestations of RMCT after blunt chest trauma is unspecific and easy to be misdiagnosed.Clinicians should pay more attention to the possibility of RMCT after blunt chest trauma.Inquiring the history of the disease,physical examination and other assistant examination in detail can help to misdiagnosis and missed diagnosis.

关 键 词：二尖瓣腱索断裂 钝性胸外伤 漏诊 

分 类 号：R654.2[医药卫生—外科学]