未成年男性左心房黏液瘤致脑栓塞患者一例报道及早期康复体会  

Report of a Minor Male Patient with Cerebral Embolism Caused by Left Atrial Myxoma and Early Rehabilitation Experience

作　　者：朱海颖 何俊[1] 卞海波 朱怡琳 李向荣 朱洁 ZHU Hai-ying;HE Jun;BIAN Hai-bo;ZHU Yi-lin;LI Xiang-rong;ZHU Jie(Rehabilitation Center,Dean Hospital of Changzhou,Changzhou 213000,China)

机构地区：[1]江苏省常州市德安医院康复中心,213000

出　　处：《实用心脑肺血管病杂志》2018年第10期117-120,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：心房黏液瘤是临床上最常见的原发性心脏肿瘤,好发于青年女性,主要累及左心房。心房黏液瘤的主要临床表现为血流动力学改变、全身表现和周围血管栓塞,如发生中枢神经系统栓塞则会引起一过性脑缺血发作、晕厥,严重者甚至发生脑栓塞。本文报道1例未成年男性左心房黏液瘤致脑栓塞患者,经开颅去骨瓣减压术及体外循环下左心房黏液瘤切除术后因存在运动、认知、言语、吞咽及平衡功能障碍及对回归学校、家庭、社会的要求较强烈而亟须进行康复治疗。笔者所在医院基于《国际功能、残疾和健康分类(ICF)》理念,从身体结构与功能、活动与参与、环境因素及个人因素等方面评估患者存在的康复问题,并制定康复目标及康复方案,康复治疗1个月后患者运动、认知、言语、吞咽及平衡功能均明显改善,且生活基本自理。Atrial myxoma,as the most primary cardiac tumors,usually occurs in young women and mainly involves left atrium.Hemodynamic changes,systemic manifestations and peripheral vascular embolism are major clinical features of atrial myxoma,but some atrial myxoma patients may perform as transient ischemic attack,syncope or even cerebral embolism due to central nervous system embolism.This paper reported a minor male patient with cerebral embolism caused by left atrial myxoma,who received bone flap decompressive craniectomy,left atrial myxoma resection under extracorporeal circulation and postoperative rehabilitation therapy due to disorders of motor function,cognitive function,speech function,swallowing function and equilibrium function,and scream for return to school,family and society.Based on ICF concept,we evaluated the rehabilitation problem according to physical structure and function,activities and participation,environmental factors and personal factors,made the rehabilitation goals and rehabilitation scheme,and1month after rehabilitation therapy,motor function,cognitive function,speech function,swallowing function and equilibrium function of the patient significantly improved,may take care of himself in daily life.

关 键 词：左心房黏液瘤 脑栓塞 未成年人 男性 康复 病例报告 

分 类 号：R750.262[医药卫生—皮肤病学与性病学]